Comparison of right and left laparoscopic live donor nephrectomy.
OBJECTIVE
To compare the anatomy and function of right and left kidneys retrieved by laparoscopic live donor nephrectomy (LDN).


METHODS
In all, 84 transperitoneal LDNs were performed, 66 left and 18 right. Two different right-sided LDN techniques were used: initially, the inferior vena cava (IVC) was controlled with a Satinsky clamp introduced through a 6-8 cm right upper quadrant incision, through which the kidney was also removed (six patients). Subsequently, the IVC was completely mobilized by laparoscopic retrocaval dissection (in 12 patients), allowing the use of a linear stapler-cutter, including the caval ostium with the renal vein. The kidney was then removed through a short Pfannenstiel incision.


RESULTS
Left kidneys had longer renal veins (38 vs 27 mm; P < 0.05), but there were no differences in arterial length (32 vs 31 mm). Three right kidneys required back-table renal vein lengthening. The operative duration was shorter for right-sided LDNs (132 vs 182 min; P < 0.05). The serum creatinine level at 3 months was 131 vs 134 mmol/L for right and left kidneys, respectively.


CONCLUSIONS
Despite faster surgery suggesting that the right LDN is technically easier, there is a greater need for back-table reconstruction of the renal vein. The functional results of right and left kidneys are equivalent.
Kay
Mark D
MD
University Hospitals of Leicester, Cardiovascular Sciences and Transplantation, Leicester, UK. markuskayus@hotmail.com
Brook
Nicholas
N
Kaushik
Monika
M
Harper
Simon J F
SJ
Bagul
Atul
A
Nicholson
Michael L
ML
D006801:Humans; D007668:Kidney / Q000033:anatomy & histology* / Q000502:physiology; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies; D012082:Renal Veins / Q000033:anatomy & histology* / Q000502:physiology; D020858:Tissue and Organ Harvesting / Q000379:methods*