title: Laparoscopic left nephrectomy for living donor kidney transplant.
abstract: OBJECTIVE
  To present our personal technique for laparoscopic left nephrectomy for living donor transplant.
  
  
  METHODS
  The surgical technique is described in detail both in the text and in a commented video. The preoperative workup includes routine blood tests, chest radiography, electrocardiography, and high-definition abdominal computed tomographic angiography with 3-dimensional reconstruction to study the vascularization of the kidney. The patient is placed in right lateral decubitus, and 4 trocars are used.
  
  
  METHODS
  The left colon is fully mobilized, the gonadic vessels and left ureter are identified, and the hilar vessels are dissected up to the origin on the renal artery from the aorta; the kidney is then mobilized. A 5- to 7-cm sovrapubic incision is made without entering the peritoneum, and a 15-mm laparoscopic bag is introduced through a small incision. The ureter and gonadic vessels are divided between clips and the main vessels are divided using an endoscopic stapler with a vascular cartridge. The kidney is quickly inserted in the endobag and removed through the sovrapubic incision.
  
  
  RESULTS
  The patients are allowed to drink the same day of the procedure, mobilized after 12 hours, and discharged on postoperative day 4 if no complications are recorded.
  
  
  CONCLUSIONS
  Laparoscopic left nephrectomy for living donor transplant can be safely performed with good results and an excellent postoperative course for the donor.
authors.affiliation: Minimally Invasive Surgery Research Center, Department of Surgical Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Viale Borri n.57, 21100 Varese, Italy. luigi.boni@uninsubria.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Giuseppe
authors.forename: Ugo
authors.initials: U
authors.lastname: Boggi
authors.forename: Andrea
authors.initials: A
authors.lastname: Pietrabissa
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D010149:Postoperative Pain / Q000503:physiopathology