title: How safe is hand-assisted laparoscopic donor nephrectomy?--results of 200 live donor nephrectomies by two different techniques.
abstract: BACKGROUND
  Despite the rapid introduction of laparoscopic living donor nephrectomy, doubts exist about safety compared with open surgery. Early series have often reported on selective donor groups. We present a consecutive, prospective analysis of morbidity following hand-assisted laparoscopic donor nephrectomy (HALDN) compared with historical controls undergoing open donation (ODN) in a total of 200 living donors at a single UK centre.
  
  
  METHODS
  The results of 144 consecutively performed HALDN donors were compared to 56 preceding ODN patients. Patients with multiple arteries, right-sided nephrectomies and obesity were included. Data on recovery and complications were collected prospectively and consecutively.
  
  
  RESULTS
  There were two (1.4%) major complications in the HALDN group and one in the ODN group (1.8%, P = 0.629). Additionally, there were 24 minor complications in 23 HADLN patients (16.7%), compared with 21 in 21 ODN patients (37.5%, P = 0.003). Time taken to return to normal activity and mean post-operative stay was significantly shorter for the HALDN group. There was no mortality in either group.
  
  
  CONCLUSIONS
  Contrary to concerns, we report a safe experience with HALDN with a low rate of major complications. Furthermore, our patients spend less time in hospital with an earlier return to normal activity compared with open donation.
authors: Department of Transplant Surgery, Renal Unit, Guy's Hospital, Guy's and St Thomas' NHS Trust, London, UK.
authors: Pankaj
authors: P
authors: Chandak
authors: Nicos
authors: N
authors: Kessaris
authors: Ben
authors: B
authors: Challacombe
authors: Jonathan
authors: J
authors: Olsburgh
authors: Francis
authors: F
authors: Calder
authors: Nizam
authors: N
authors: Mamode
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods*