Laparoendoscopic Single-Site Donor Nephrectomy Video

Abstract

Introduction: Laparoendoscopic single-site (LESS) surgery is a modification of multiport or conventional laparoscopy. Utilizing a single site for access, LESS attempts to minimize the number of scars produced. This may result in improvements in pain, convalescence, and cosmesis. Outcomes, however, must not be compromised using this approach. At our institution, we have performed LESS donor nephrectomy (LESS-DN) and have compared it to conventional laparoscopic donor nephrectomy (LDN) in a prospective, randomized fashion to assure that LESS-DN outcomes are not inferior to LDN. The technique and the outcomes of our trial are outlined in the video. Methods: LESS-DN access is obtained through the extraction pfannenstiel incision. Three ports are placed within this incision and donor nephrectomy is performed with the aid of the EndoEye articulating scope. The colon is reflected after incising the white line of Toldt, and the ureter is identified. Dissection toward the hilum is performed and the renal artery and vein are skeletonized with branching vessels ligated and transected with hemolock clips. The lateral and upper pole renal attachments are freed and the renal artery and vein are staple ligated. The kidney is placed in an endocatch bag and extracted through the pfannenstiel incision. Results: LDN and LESS-DN were performed in 14 and 15 patients, respectively. Patients had similar parameters on study entry and had similar outcomes with LESS-DN patients enjoying less pain on postoperative days 1 and 2. Conclusion: LESS-DN is safe, feasible, and comparable to LDN. LESS-DN may result in improvement in pain and convalescence. Number of scars are decreased with the use of LESS-DN. No competing financial interests exist. Runtime of video: 5 mins 37 secs