V1729 LAPAROSCOPIC LIVING DONOR NEPHRECTOMY WITH THE USE OF 3 MM INSTRUMENTS AND LAPAROSCOPE

Abstract

You have accessJournal of UrologyTransplantation and Urolithiasis1 Apr 2013V1729 LAPAROSCOPIC LIVING DONOR NEPHRECTOMY WITH THE USE OF 3 MM INSTRUMENTS AND LAPAROSCOPE Alberto Breda, Giuseppe Lucarelli, Oscar Rodríguez Faba, Lluís Gausa, Javier Ponce de León, and Humberto Villavicencio Alberto BredaAlberto Breda Barcelona, Spain More articles by this author , Giuseppe LucarelliGiuseppe Lucarelli Barcelona, Spain More articles by this author , Oscar Rodríguez FabaOscar Rodríguez Faba Barcelona, Spain More articles by this author , Lluís GausaLluís Gausa Barcelona, Spain More articles by this author , Javier Ponce de LeónJavier Ponce de León Barcelona, Spain More articles by this author , and Humberto VillavicencioHumberto Villavicencio Barcelona, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2930AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopy has become the standard of care for kidney retrieval during laparoscopic live donor nephrectomy (LLDN). In the donor population the cosmetic results are of great importance and multiple minimal invasive techniques have been developed. While robotic surgery has not gain in popularity in the LLDN population, single port surgery is becoming very attractive, even if technically challenging. On the contrary, needlescopic surgery may offer advantages over single port surgery due to the fact that it reproduces the standard principle of laparoscopy while minimizing the incision size. In this video we present our experience with LLDN with the use of 3 mm instruments and laparoscope. METHODS Between Nov 2010 and Oct 2012 all potential donors with a BMI<30 were consented to undergo a LLDN with the use of 3 mm instruments. In all cases a left kidney was preferred. All cases were performed through a transperitoneal access. Pneumoperitoneum was obtained with the Veress Needle. A 5 mm visiport was introduced at the level of the humbilicus. This was to allow the use of a 5 mm Ligasure and to guarantee the pneumoperitoneum that would not be otherwise possible to maintain through a 3 mm trocar. Four 3 mm trocars were introduced along the pararectal line at the tip of the 12th rib. A 3 mm optic was used together with 3 mm scissors and bipolar. At the end of the procedure, right before hilar clamping, a 5 cm Pfannestiel incision was performed at the level of the pubic hairline with the creation of a subcutaneous flap to the level of the umbilicus. A 15 mm trocar was thereafter inserted to allow the Endo-GIA entrance as well as the Endo-bag. RESULTS 7 LLDN were performed with this technique (4 M and 3F). The avarage age was 42 and the mean BMI was 25. Left LLDN was performed in all cases. Two donors had two arteries and a retroaortic vein. The other 4 donors had single artery and vein. Mean operative time was 164 minutes and mean warm ischemia time was 2.9 minutes. There were no intraopertive and postoperative major complications although one donor developed a subcutaneous seroma that was managed conservatively. All patients were satisfied with their cosmetic results as documented by the low score on the Patient Scar Assessment Questionnaire and Scoring System (PSAQ). CONCLUSIONS LLDN with the use of 3 mm instruments appears to be reproducible and safe since it preserves the general principle of laparoscopy while minimizing the incision size. We hope that this small study will serve as preliminary data for further investigation in the field of needlescopic surgery in LLDN. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e710 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Breda Barcelona, Spain More articles by this author Giuseppe Lucarelli Barcelona, Spain More articles by this author Oscar Rodríguez Faba Barcelona, Spain More articles by this author Lluís Gausa Barcelona, Spain More articles by this author Javier Ponce de León Barcelona, Spain More articles by this author Humberto Villavicencio Barcelona, Spain More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...