Abstract
BackgroundTransplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee the donor's safety, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy experienced by the donor. However, this method is characterised by higher in hospital costs, longer operating times and it requires a well-trained surgeon. The hand-assisted retroperitoneoscopic technique may be an alternative to a complete laparoscopic, transperitoneal approach. The peritoneum remains intact and the risk of visceral injuries is reduced. Hand-assistance results in a faster procedure and a significantly reduced operating time. The feasibility of this method has been demonstrated recently, but as to date there are no data available advocating the use of one technique above the other.Methods/designThe HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs.DiscussionThis study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy.Trial RegistrationDutch Trial Register NTR1433
Highlights
Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure
This study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy
Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves
Summary
Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. We demonstrated the benefit of laparoscopic nephrectomy (LDN) to the donor This method is characterised by higher in-hospital costs, longer operating times and requires a well-trained surgeon [2]. The hand-assistance results in a faster procedure and a significantly reduced operating time [3-7] The feasibility of this method has been demonstrated recently, but as to date studies advocating the use of one technique above the other are lacking. In comparison to minimally invasive open techniques, laparoscopic kidney donation is associated with a better quality of life, less pain, shorter in hospital stay and earlier return to work This method is expensive for the hospital, has a long operating time and requires an experienced, well-trained, surgeon [2,8,9]. There is no randomized controlled trial comparing both techniques for the effectiveness [3-6]
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