title: What is the most preferred wound site for laparoscopic donor nephrectomy?: a questionnaire assessment.
abstract: BACKGROUND
  Although specimen extraction site selection for laparoscopic donor nephrectomy (LDN) is relatively flexible and is mostly selected by surgeons from the patient's standpoint, the patient's request may differ from the medical worker's recommendation. The cosmetic aspect may also differ with age, gender, and the extent of medical knowledge. We performed an unsigned questionnaire assessment of individual preferences for LDN wound sites.
  
  
  METHODS
  Between August 2007 and October 2008, we surveyed LDN wound site preferences among 148 physicians, 263 nurses, and 266 outpatients of urology at Akita University Hospital. They were questioned for their age, gender, occupation (medical worker or not), and for the most preferred surgical wound site among the following: A, lower vertical midline: B, upper vertical midline: C, anterior subcostal: D, Pfannenstiel: E, Gibson: and F, subcostal flank. The valid response rate was 93.5% (677/724).
  
  
  RESULTS
  Wound sites preferred (ranked in descending order) were F (48.3%), D (25.6%), E (10.5%), A (9.0%), C (5.2%), and B (1.4%). The subcostal flank incision was the most preferred in almost all the categories. Second preferences were Pfannenstiel incisions in women and incisions on the lower abdomen in men. Overall, flank and lower abdominal incisions tended to be preferred, and mid and upper abdominal incisions tended to be avoided. Medical workers selected the subcostal flank and Pfannenstiel incisions more frequently than outpatients. With increasing age, the selection rates of the Gibson and the lower vertical midline incisions increased, whereas the subcostal flank and the Pfannenstiel incisions decreased.
  
  
  CONCLUSIONS
  The subcostal flank was the most preferred LDN sites. Age, gender, and the extent of medical knowledge may influence the individual preferences for LDN wound sites.
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Saito
authors.forename: Norihiko
authors.initials: N
authors.lastname: Tsuchiya
authors.forename: Shinya
authors.initials: S
authors.lastname: Maita
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Numakura
authors.forename: Takashi
authors.initials: T
authors.lastname: Obara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuruta
authors.forename: Teruaki
authors.initials: T
authors.lastname: Kumazawa
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Inoue
authors.forename: Shintaro
authors.initials: S
authors.lastname: Narita
authors.forename: Yohei
authors.initials: Y
authors.lastname: Horikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yuasa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Satoh
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D057240:Patient Preference; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D060053:Transplant Donor Site / Q000601:surgery*; D055815:Young Adult