Hand-assisted laparoscopic live donor nephrectomy (right-sided approach): experience obtained from 31 cases.
BACKGROUND
The removal of a donor kidney by laparoscopic nephrectomy is a safe method that is widely used, mainly in left donor nephrectomy. However, for right donor nephrectomy where the right renal vein is short, open surgery has been more frequently described in the literature.


OBJECTIVE
Our objective was to describe our experience with 31 renal transplantations using 2 different techniques in right donor nephrectomy.


METHODS
In the period ranging from February 2002 to June 2005, we performed, 31 hand-assisted laparoscopic right donor nephrectomies. Twenty-five were performed by the method where the assistant used his hand to assist the surgery and 6 were by the laparoscopic method assisted by the first surgeon.


RESULTS
The right donor nephrectomies assisted either by the hand of the assistant or the surgeon showed similar results. All recipients displayed diuresis in the immediate postoperative period. The serum creatinine level at 1 week after transplantation was 1.90 mg/dL (+/-1.55).


CONCLUSIONS
Although the handling techniques are similar, we concluded that laparoscopic nephrectomy assisted by the surgeon is more adequate for right kidney extraction. It can be performed either by a resident doctor or a surgeon of the transplantation team, with or without experience in nephrectomy for transplantation.
Maciel
R F
RF
Central de Transplantes do Agreste, Casa de Saude Santa Efigênia, Caruaru, Pernambuco, CEP 54400-010 Brazil. rfmaciel@uol.com.br
D016063:Blood Loss, Surgical; D004231:Diuresis; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*