Laparoscopic Donor Nephrectomy: Ramathibodi Hospital Experience

Authors

  • Thitawat Wongampornpat Department of Urology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
  • Wisoot Kongcharoensombat Department of Urology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
  • Kittinut Kijvikai Department of Urology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand

Keywords:

laparoscopic, donor, nephrectomy, ramathibodi, experience

Abstract

Introduction: Laparoscopic donor nephrectomy (LDN) is performed increasingly to improve donor outcomes, by reducing perioperative morbidity without compromising on allograft function in the recipient. We report our initial experience with standard and hand-assisted LDN.

Materials and Methods: From August 2007 to February 2009, 35 cases of standard and hand-assisted LDNs were performed in our institute. Potential donors were evaluated for suitability, which included a renal CT angiogram. During hand assisted surgery, dissection of the donor kidney was performed laparoscopically, aided by the surgeonûs non-dominant hand inserted into the abdominal cavity through a hand-assist device via a 7.5 -cm abdominal incision. The renal allograft was subsequently delivered through the incision.

Results: The mean operating time was 140.0 +/- 30 minutes and the mean warm ischemic time was 2.00 +/ - 0.5 minutes. There was one case of right side nephrectomy. There was one conversion to the open technique due to clip dislodgement. Postoperatively, patients returned to normal diet by 1.0 +/- 0.5 days. On average, the patients started ambulation at 2.0 +/- 0.9 days and were discharged 3 +/- 1.5 days after surgery. There were no significant major complications. All grafts had immediate graft function. Serum creatinine levels of all recipients fell down within 24 hours and reached baseline at a mean of one week.

Conclusion: Standard and hand-assisted LDN is safe, feasible and can be performed with minimal morbidity. It also allows for excellent allograft function.

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References

Breda A, Bui MH, Liao JC, Gritsch HA, Schulam PG. Incidence of Ureteral Strictures After Laparoscopic Donor Nephrectomy. J Urol 2006; 176(3): 1065-8.

Duchene DA, Johnson DB, Li S, Roden JS, Sagalowsky AI, Cadeddu JA. Laparoscopic Donor Nephrectomy At A Low Volume Living Donor Transplant Center: Successful Outcomes Can Be Expected. J Urol 2003; 170(3): 731-3.

Ruiz-Deya G, Cheng S, Palmer E, Thomas R, Slakey D. Open Donor, Laparoscopic Donor And Hand Assisted Laparoscopic Donor Nephrectomy: A Comparison Of Outcomes. J Urol 2001; 166: 1270-4.

Janetschek G, Bagheri F, Abdelmaksoud A, Biyani CS, Leeb K, Jeschke S. Ligation of the renal vein during laparoscopic nephrectomy: an effective and reliable method to replace vascular staplers. J Urol 2003; 170(4): 1295-7.

El Fettouh HA, Herts BR, Nimeh T, Wirth SL, Caplin A, Sands M, et al. Prospective Comparison Of 3-Dimensional Volume Rendered Computerized Tomography And Conventional Renal Arteriography For Surgical Planning In Patients Undergoing Laparoscopic Donor Nephrectomy. J Urol 2003 170(3): 57-60.

Wolf JS Jr, Moon TD, Nakada SY. Hand Assisted Laparoscopic Nephrectomy: Comparison To Standard Laparoscopic Nephrectomy. J Urol 1998; 160(1): 22-7.

Del Pizzo JJ, Sklar GN, You-Cheong JW, Levin B, Krebs T, Jacobs SC. Helical Computerized Tomography Arteriography For Evaluation Of Live Renal Donors Undergoing Laparoscopic Nephrectomy. J Urol 1999; 162: 31-4.

Perry KT, Freedland SJ, Hu JC, Phelan MW, Kristo B, Gritsch AH, et al. Quality Of Life, Pain And Return To Normal Activities Following Laparoscopic Donor Nephrectomy Versus Open Mini-Incision Donor Nephrectomy. J Urol 2003; 169: 2018-21.

Aliasgari M, Shakhssalim N, Dadkhah F, Ghadian A, Moghaddam SM. Donor Nephrectomy With and Without Preservation of Gonadal Vein While Dissecting the Ureter. J Urol 2008; 5(3): 168-72.

Stifelman MD, Hull D, Sosa RE, Su LM, Hyman M, Stubenbord W, et al. Hand Assisted Laparoscopic Donor Nephrectomy: A Comparison With The Open Approach. J Urol 2001; 166: 444-8.

Harryman OA, Davenport K, Keoghane S, Keeley FX, Timoney AG. A Comparative Study of Quality of Life Issues Relating to Open Versus Laparoscopic Nephrectomy: A Prospective Pragmatic Study. J Urol 2009; 181: 998-1003.

Fisher PC, Montgomery JS, Johnston WK 3rd, Wolf JS Jr. 200 Consecutive Hand Assisted Laparoscopic Donor Nephrectomies: Evolution of Operative Technique and Outcomes. J Urol 2006; 175: 1439-43.

Parra RO, Perez MG, Boullier JA, Cummings JM. Comparison Between Standard Flank Versus Laparoscopic Nephrectomy For Benign Renal Disease. J Urol 1995; 153: 1171-4.

El-Galley R, Hood N, Young CJ, Deierhoi M, Urban DA. Urban, Donor Nephrectomy: A Comparison of Techniques And Results Of Open, Hand Assisted And Full Laparoscopic Nephrectomy. J Urol 2004; 171(1): 40-3.

Brown SL, Biehl TR, Rawlins MC, Hefty TR. Laparoscopic Live Donor Nephrectomy: A Comparison With The Conventional Open Approach. J Urol 2001; 165: 766-9.

Jacobs SC, Cho E, Dunkin BJ, Flowers JL, Schweitzer E, Cangro C, et al. Laparoscopic Live Donor Nephrectomy: The University Of Maryland 3-Year Experience. J Urol 2000; 164(5) 1494-9.

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Published

2010-12-01

How to Cite

Wongampornpat, T., Kongcharoensombat, W., & Kijvikai, K. (2010). Laparoscopic Donor Nephrectomy: Ramathibodi Hospital Experience. Insight Urology, 31(2), 112–117. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/252401

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