Hand-Assisted Laparoscopic Live Donor Nephrectomy - Right-Sided Approach: Experience Attained in 46 Cases.

Abstract

Removal of a donor kidney by laparoscopic nephrectomy is a safe method, and it is being widely used especially in left donors nephrectomies. However, since the right renal vein is too short, open surgery for right donors has been more frequently described in the literature. Purpose: To describe our experience in 46 renal transplants using two different techniques in right donor nephrectomy. Method: From February, 2002 to February of 2014, 46 right donor nephrectomies were performed, where twenty five of those were performed by the method with the assistant using his hands to assist the surgery, and twenty one were performed by laparoscopic method assisted by the first surgeon. Results: Both methods of nephrectomy, either by the hand of the assistant or the main surgeon, had similar results. All recipients had diuresis in the immediate post-operative period, and one week after the transplant, serum creatinine was found to be 2.90mg/dL, and 1.85mg/dL by the second week.Conclusion: Although both hand techniques are similar we concluded that the laparoscopic nephrectomy assisted by the surgeon is more adequate for the right kidney extraction. It can be performed either by a resident doctor or a surgeon from the transplantation team whether experienced or not in nephrectomy for transplantation. Key Words: Kidney Transplantation, Nephectomy, Laparoscopy, Treatment Outcome.