Improvement and effect of retroperitoneal laparoscopic living donor nephrectomy

Abstract

Objective To improve the technology of retroperitoneal laparoscopic living donor nephrectomy and observe its clinical effect.Methods Forty-one cases of living donors subject to nephrectomy by the new retroperitoneal laparoscopic technique from July 2009 to June 2012 were retrospectively.The new technique was modified as follows: (1) Alternate use of blunt dissection,sharp dissection and harmonic scalpel; (2) After separation of renal vein,artery and ureter,a 5-6 cm incision parallel to rectus abdominis from Trocar was made in order to put a hand inside retroperitoneum; (3) A biopsy of the kidney was made from Trocar with the help of a hand for holding the kidney; (4) Pulling the kidney with a proper strength and blocking renal artery and renal vein with Hem-o-lock,then cutting off them and taking out the kidney.Results Forty-one cases of live donors subject to nephrectomy were operated on successfully,and were not converted to open operation.The operative time was 65-130 min (mean 85 min).The warm ischemia time was 58-110 s (average 78 s).Living donor kidney artery length was 2.1-3.7 cm (average 2.9 cm).Living donor kidney vein length was 2.5-4.1 cm (average 3.5 cm).Blood loss was 15-80 ml (average 28 ml).Hospital stay after surgery was 4-7 days (average 4.8 days).All biopsy specimens were achieved from 41 cases.None suffered from complications except two cases of perilymphorrhea.Forty-one recipients recovered well after renal transplantation.Conclusion The improved retroperitoneal laparoscopic living donor nephrectomy is considered to be safe,effective and feasible.It is a good way to protect renal function and reduce injury. Key words: Kidney transplantation; Living donors; Laparoscopes; Retroperitoneum