Laparoendoscopic Single-site Donor Nephrectomy: A Single-center Experience

Abstract

To present our experience with 13 patients undergoing laparoendoscopic single-site live donor nephrectomy. The Quadport/Triport (Advanced Surgical Concepts, Ireland) was inserted through an incision in the umbilicus. Apart from standard laparoscopic instruments, we used extra-long harmonic scalpel, suction, and bent instruments, particularly for upper pole dissection. After securing the hilum, the graft was brought near the umbilical extraction site with a grasper inserted through an extra 3- or 5-mm port and easily retrieved with the help of 2 fingers. The parameters analyzed were warm ischemia time, operative time, blood loss, postoperative visual analogue score, grafts retrieval time, and artery, vein, and ureteral length. Mean body mass index was 22.18 +/- 3.42 kg/m(2) (range 17.9-29.78). The mean operative time, blood loss, warm ischemia time, and hospital stay were 176.9 +/- 42.47 minutes, 158 +/- 78 mL, 6.79 +/- 1.7 minutes, and 3 +/- 0.45 days (range 2-5), respectively. Graft artery, vein, and ureteral length was 3.8 +/- 0.4, 4 +/- 0.12, and 14.5 cm (range 13-16), respectively. The urine output was prompt in all cases. Visual analogue score in the donor at 2 weeks was 0/10 in all cases. Eleven patients required extra 3- or 5-mm port. Cosmesis was excellent, with the mean incision length of 5.23 +/- 0.96 cm. The laparoendoscopic single-site donor nephrectomy in our initial experience is efficacious and a feasible, minimally invasive option for donors in renal transplantation. Further prospective studies with conventional laparoscopic donor nephrectomy are required to establish its current status.