title: [Surgical aspects of living donor nephrectomy].
abstract: BACKGROUND
  Living donor renal transplant surgery has evolved from the classical nephrectomy by lumbotomy to less invasive surgery, the laparoscopic and robotic nephrectomy currently being the most important. It is important to know the available evidence on whether nephrectomy in patients with multiple arteries, right kidney and in obese patients can be performed safely when there is a correct indication.
  
  
  OBJECTIVE
  To perform a review of the different surgical techniques in living donor nephrectomy, adapted to the current surgical evidence and other aspects related to the indication.
  
  
  METHODS
  A systematic review was made in PubMed (1997-2011). This included previous reviews randomized controlled clinical studies, cohort studies, and meta-analyses of this surgical aspects of living donor nephrectomy.
  
  
  CONCLUSIONS
  Currently, there is sufficient evidence to consider living donor laparoscopic nephrectomy as the technique of choice, although the role of hand-assisted retroperitoneoscopic technique is still not totally clear. Open surgery techniques using mini-incision are an acceptable alternative for the sites that have not yet implemented laparoscopic surgery. Right kidney nephrectomy, of those cases that present multiple pedicles and in obese donors, is justified in selected cases.
authors: Unidad de Trasplante Renal, Servicio de Urología, Fundació Puigvert, Barcelona, España.
authors: O
authors: O
authors: Rodríguez
authors: A
authors: A
authors: Breda
authors: S
authors: S
authors: Esquena
authors: H
authors: H
authors: Villavicencio
mesh_terms: D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*