title: Laparoendoscopic single-site plus one trocar donor nephrectomy using the GelPort: initial clinical experience.
abstract: OBJECTIVE
  To achieve better cosmesis, less invasiveness, and less morbidity in donor nephrectomy without using specialized instruments, which is usually required in the laparoendoscopic single-site (LESS) procedure, we performed laparoendoscopic plus one trocar donor nephrectomy (LEPODN).
  
  
  METHODS
  From October 2010 to December 2011, 20 living renal transplantation donors underwent the LEPODN procedure. Their mean age, body mass index (BMI), and preoperative creatinine clearance were 55.7 years, 23.2, and 118.4 mg/min, respectively. The GelPort laparoscopic system was inserted through a 5-6 cm pararectal incision at the umbilicus level. A subcostal 5-mm right-hand working trocar was placed under the left costal arch. The graft kidney was extracted using a retrieval bag. A 5-mm diameter drain was placed via a right-hand working trocar. Operative data of LEPODN were retrospectively compared to those of standard laparoscopic donor nephrectomy (standard-LDN, n = 27) previously performed at our hospital.
  
  
  RESULTS
  The procedure was technically successful in all 20 patients. The mean operative time in the LEPODN group was significantly shorter than that in the standard-LDN group (229.1 vs 249.8 minutes, P = .033). Mean blood loss and warm ischemic time in the LEPODN group were 39.4 mL and 272.4 seconds, respectively. The mean serum creatinine concentrations of the recipients 7 and 30 days after operation were 1.57 and 1.13 mg/dL, respectively. These results were not significantly different from those in the standard-LDN group.
  
  
  CONCLUSIONS
  The LEPODN procedure was feasible and performed without specialized instruments by surgeons experienced in only standard laparoscopic nephrectomy.
authors: Department of Urology, Akita University Graduate School of Medicine, Akita, Japan.
authors: Takamitsu
authors: T
authors: Inoue
authors: Norihiko
authors: N
authors: Tsuchiya
authors: Shintaro
authors: S
authors: Narita
authors: Mitsuru
authors: M
authors: Saito
authors: Shinya
authors: S
authors: Maita
authors: Kazuyuki
authors: K
authors: Numakura
authors: Takashi
authors: T
authors: Obara
authors: Hiroshi
authors: H
authors: Tsuruta
authors: Yohei
authors: Y
authors: Horikawa
authors: Shigeru
authors: S
authors: Satoh
authors: Tomonori
authors: T
authors: Habuchi
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000295:instrumentation / Q000379:methods*; D052096:Warm Ischemia
chemical_list: D003404:Creatinine