title: Technical modifications of retroperitoneoscopic live donor nephrectomy: Chinese experience.
abstract: OBJECTIVE
  The objective of this article is to report a single-center experience and technical modifications of retroperitoneoscopic live donor nephrectomy (RPLDN).
  
  
  METHODS
  One hundred twenty-one 3-port RPLDNs were performed at our institution. No prisoners or organs from prisoners were used to collect the data for this study. The tributaries of renal artery and vein were transected using a harmonic scalpel after both ends of the tributary were coagulated intermittently until the color turned light yellow. Transection was made using shifting coagulation. A longitudinal 6-8-cm skin incision was extended inferiorly from the primary trocar with muscles intact. The renal artery was clipped using two Hem-o-Lok clips at the proximal end, and then sheared by scissors without any clips on the kidney side. The renal vein was controlled similarly. The graft was retrieved by insertion of a hand through the longitudinal lumbar incision.
  
  
  RESULTS
  The mean operative time and warm ischemia time were 126.1 and 3.6 minutes, respectively. No blood transfusion or open conversion was required. None of the donors encountered a major complication, but 7 suffered minor complications. Preoperative and postoperative mean serum creatinine levels of the donors were 1.00 and 1.29 mg/dL, respectively. The mean serum creatinine levels of the recipients postoperatively at day 1 and month 1 were 5.48 and 1.60 mg/dL, respectively.
  
  
  CONCLUSIONS
  The modified approach of RPLDN may be a useful alternative with flexible control of the renal vessels and tributaries and easy retrieval of the graft.
authors.affiliation: Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China. bysyuro@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Ma
authors.forename: J
authors.initials: J
authors.lastname: Ye
authors.forename: X
authors.initials: X
authors.lastname: Tian
authors.forename: G
authors.initials: G
authors.lastname: Wang
authors.forename: X
authors.initials: X
authors.lastname: Hou
authors.forename: L
authors.initials: L
authors.lastname: Zhao
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002681:China; D003404:Creatinine / Q000097:blood; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012077:Renal Artery / Q000601:surgery*; D012082:Renal Veins / Q000601:surgery*; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D052096:Warm Ischemia
chemical_list: D015415:Biomarkers; D003404:Creatinine