Hand-assisted laparoscopic right donor nephrectomy: safety and feasibility.
OBJECTIVE
We aimed to prove the safety and feasibility of right-sided hand-assisted laparoscopic donor nephrectomy (HALDN).


METHODS
Between May 2006 and May 2009, 16 patients underwent right-sided HALDN at our institution. Of these patients, 15 showed significantly lower renal function in the right kidney than in the left one and 1 had a stone in the right kidney. When the right renal vein was divided, an EndoGIA stapling device was placed on the wall of the inferior vena cava to gain a maximal length of the vein. We evaluated intraoperative and postoperative parameters such as operative time, delivery time, warm ischemic time, estimated blood loss, intraoperative and postoperative complication rates, length of hospital stay, and serum creatinine levels of donors (at the time of discharge) and recipients (4 weeks postoperatively), comparing the right-sided HALDN group (our study) with a left-sided HALDN group (from a previously reported study).


RESULTS
A total of 16 right-sided HALDNs were successfully performed without any complications or open conversion. All of the intraoperative and postoperative parameters were similar between the right-sided HALDN and left-sided HALDN groups. There were no technical problems in the recipients in the anastomosis of the renal vein, and the ureteral anastomoses were also successful.


CONCLUSIONS
Right-sided HALDN is safe and technically feasible in a donor, showing favorable graft outcomes. The results of our study suggest that right-sided HALDN may be preferable in patients with significantly lower renal function in the right kidney than in the left one.
Chung
Moon-Soo
MS
Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea.
Kim
Su Jin
SJ
Cho
Hyuk Jin
HJ
Ha
U-Syn
US
Hong
Sung-Hoo
SH
Lee
Ji Youl
JY
Kim
Joon Chul
JC
Kim
Sae Woong
SW
Hwang
Tae Kon
TK