You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery II1 Apr 20102166 TRANSVAGINALLY NOTES-ASSISTED LAPAROSCOPIC LIVING DONOR NEPHRECTOMY Antonio Alcaraz, Mireia Musquera, Lluis Peri, Alejandro Molina, Pedro Campillo, Mertixell Pérez, and Maria J. Ribal Antonio AlcarazAntonio Alcaraz More articles by this author , Mireia MusqueraMireia Musquera More articles by this author , Lluis PeriLluis Peri More articles by this author , Alejandro MolinaAlejandro Molina More articles by this author , Pedro CampilloPedro Campillo More articles by this author , Mertixell PérezMertixell Pérez More articles by this author , and Maria J. RibalMaria J. Ribal More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2269AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As published recently, transvaginal hybrid natural orifice transluminal endoscopic surgery (NOTES) radical nephrectomy is a feasible and reproductible treatment for kidney tumours with complication rate, outcomes and results comparable to standard laparoscopic approach. We present our first experience in transvaginally NOTES-assisted laparoscopic living donor nephrectomy. METHODS Between July and November 2009, 4 women were submitted to transvaginal NOTES-assisted living donor nephrectomy in our center. Surgical procedure: 3 abdominal ports were placed (12mm umbilical port, 5mm left iliac fossa and 5mm next to the ribs). A 12 mm port was placed transvaginally through the Douglas pouch. The transvaginal port was used for the assistance of instruments during different moments of the surgery. After completely release of the whole kidney and vascular pedicle were dissected, an endobag device was introduced through the vagina hole. When the kidney was placed inside the bag, the metallic ring permitted to apply a gentle traction on the vessels to perform a safety section. Two Hemo-locks were placed in the proximal ends of the artery and vein. The kidneys were removed through the vagina with the bag and a careful transfer to the surgery bench avoided any infection from vaginal bacteria. RESULTS The procedure was completed in all cases. The mean age of women was 51.25 years old. All donors had had vaginal deliveries (2, 3 and 5), and gynaecological explorations showed complaisant vaginas. In one case, C-section surgery had been done. All cases had bilateral simple pedicles, so a left nephrectomy was decided. The mean operative time was 137.5 min (105-165 min), and the estimated blood loss was 200cc. No intra or post-operative complication occurred. Mean warm isquemia time was 5 minutes and 39 seconds and the length of hospital stay was 3 days. In all cases, kidney transplantation was performed safely without any complication. Vessels were long enough to perform comfortable anastomoses. CONCLUSIONS Laparoscopic transvaginal approach for living donor nephrectomy is a feasible and save procedure and could be suggested as a real alternative to conventional laparoscopic nephrectomy in living donor, further analysis is warranted. Barcelona, Spain© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGoldfarb D (2018) Re: Laparoscopic Live Donor Nephrectomy With Vaginal Extraction: Initial ReportJournal of Urology, VOL. 185, NO. 2, (612-612), Online publication date: 1-Feb-2011. Volume 183Issue 4SApril 2010Page: e842-e843 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio Alcaraz More articles by this author Mireia Musquera More articles by this author Lluis Peri More articles by this author Alejandro Molina More articles by this author Pedro Campillo More articles by this author Mertixell Pérez More articles by this author Maria J. Ribal More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...