title: Single-port live donor nephrectomy using a novel Curved Radius r2 Surgical System in an in vivo model.
abstract: OBJECTIVE
  Single-port laparoscopic donor nephrectomy provides low morbidity and satisfactory cosmetic results for patients. The aim of this animal study was to establish a surgical technique of single-site (LESS) living donor nephrectomy using novel curved r2 CURVE manipulators specially designed for single-port access.
  
  
  METHODS
  A total of six LESS nephrectomies were performed in three female pigs. r2 CURVE-instruments (Tuebingen Scientific Medical GmbH) were used providing a curved rotatable shaft, endless tip rotation, as well as 90° tip deflection. A 10 mm 30° extra long laparoscope, r2-curved Grasper, Maryland dissector and bipolar scissors were used for mobilization and dissection.
  
  
  RESULTS
  All LESS nephrectomies were performed successfully. Average operative time was 80 min (range, 42-149 min). No technical problems were observed. Insertion and extraction of the instruments through the single-port were easy to conduct. The diameter of the used single-port was sufficient for safe manual organ harvesting. Potential conflict between the laparoscope and the instrument handles was avoided by using an extra long laparoscope.
  
  
  CONCLUSIONS
  The new curved and deflectable instruments showed that single-port nephrectomy using the R2 manipulators is feasible. Single-port laparoscopic nephrectomy might be more patient-friendly and improve the willingness of potential donors to donate live organs.
authors.affiliation: Department General, Visceral and Transplant Surgery, University Hospital Tübingen , Tübingen , Germany.
authors.forename: Marty
authors.initials: M
authors.lastname: Zdichavsky
authors.forename: Martina
authors.initials: M
authors.lastname: Krautwald
authors.forename: Tobias
authors.initials: T
authors.lastname: Meile
authors.forename: Dörte
authors.initials: D
authors.lastname: Wichmann
authors.forename: Jessica
authors.initials: J
authors.lastname: Lange
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Marc Oliver
authors.initials: MO
authors.lastname: Schurr
mesh_terms: D000818:Animals; D005260:Female; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D013552:Swine; D020858:Tissue and Organ Harvesting / Q000379:methods*
keywords: Curved Radius Surgical System; experimental; laparoscopic; live donor nephrectomy; pig study