Retroperitoneal less donor nephrectomy

A Van Der Merwe,A Bachmann,C F Heyns

doi:10.1590/s1677-55382010000500010

Abstract

Donor nephrectomy with laparo-endoscopic single site (LESS) surgery has been reported via the transperitoneal approach. We describe a novel technique of retroperitoneal donor nephrectomy using a single surgical incision in the groin, below the abdominal skin crease or "bikini line". The LESS groin incision offers superior cosmesis, while the retroperitoneal approach has distinct advantages, such as the ability to identify the renal vessels early. The new procedure has been performed in two obese patients (body mass index 32 and 33 kg/m2, respectively). The operative times were 4 and 5 hours, warm ischemic times 135 and 315 seconds, blood loss 100 and 250 mL, and hospitalization 3 and 2 days, respectively. Retroperitoneal LESS donor nephrectomy through a single, inconspicuous groin incision is feasible and safe. Further evaluation of the technique in a larger patient cohort is indicated.

Highlights

The first laparoscopic live donor nephrectomy was reported by Ratner et al in 1995 and retroperitoneal endoscopic donor nephrectomy was described by Yang et al in the same year [1,2]
Laparo-endoscopic single site (LESS) donor nephrectomy is in its infancy and the optimal technique has yet to be established
The authors have combined experience of more than 250 cases of retroperitoneal donor nephrectomy and felt it safe to proceed to single site surgery for this operation

Summary

Retroperitoneal LESS Donor Nephrectomy

Vol 36 [5]: 602-608, September - October, 2010 doi: 10.1590/S1677-55382010000500010 Department of Urology (AVM, CFH), University of Stellenbosch and Tygerberg Hospital, Cape Town, South Africa and Department of Urology (AB), University Hospital Basel, Basel, Switzerland

INTRODUCTION

SURGICAL TECHNIQUE

Findings

EDITORIAL COMMENT