Laparoscopic Donor Nephrectomy: Ramathibodi Hospital Experience
Keywords:
laparoscopic, donor, nephrectomy, ramathibodi, experienceAbstract
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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