Comparative study of laparoscopic and mini-incision open donor nephrectomy: have we heard the last word in the debate?

Abstract

Laparoscopic donor nephrectomy (LDN) is generally considered a better option than open donor nephrectomy (ODN) as it is associated with better cosmesis, less post-operative pain and faster recovery. Mini-incision donor nephrectomy (MDN) has proven to be an effective and less invasive modification of classic ODN. Our aim was to compare the peri-operative outcomes and quality of life of donors following laparoscopic and mini-incision ODN. One hundred patients, underwent donor nephrectomy using laparoscopic approach (n = 50) or open mini-incision approach (n = 50) over a period of 18 months. Data were entered into a prospective database and analyzed retrospectively. The mean operative (skin to skin) time for MDN, 53.9 min (range, 40-75 min), was significantly shorter than the 93.7 min (range, 75-140 min) for LDN. The laparoscopic donors had a longer hospital stay, warm ischemia time and higher operative and post-operative cost. There was no significant difference in the pain scores, graft function, or quality of life between the two groups. MDN compares well with the laparoscopic approach in terms of post-operative pain, graft function and quality of life of donors. Significantly less operative time along with the reduced cost makes it a better option in our predominantly lower BMI patient population.