Hand-assisted transperitoneal laparoscopic living donor nephrectomy

Cai, M.; Shi, B.; Qian, Y.; Mo, C.; Du, G.; Bai, H.; Wang, Y.; Zheng, D.; Que, S.; Chen, Z.K.

doi:10.1016/j.transproceed.2004.06.055

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Volume 36, Issue 7 , Pages 1903-1904, September 2004

Hand-assisted transperitoneal laparoscopic living donor nephrectomy

M. Cai
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
- The Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and technology, Wuhan China (M.C., K.C.)
B. Shi
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
- Address reprint requests to Bingyi Shi, MD, A17 Heishanhu Road, Haidian District, Department of Urology, PLA 309 Hospital, Beijing 100091, China
Y. Qian
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
C. Mo
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
G. Du
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
H. Bai
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
Y. Wang
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
D. Zheng
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
S. Que
- Department of Urology, Beijing, China (M.C., B.S., Y.Q., C.M., G.D., H.B., Y.W., D.Z., S.Q.)
Z.K. Chen
- The Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and technology, Wuhan China (M.C., K.C.)

Abstract

Objective

We introduced and evaluated the advantages and disadvantages of the hand-assisted transperitoneal laparoscopic technique for living donor nephrectomy.

Materials and methods

In December 2001, we started using the technique of hand-assisted transperitoneal laparoscopic living donor nephrectomy (HLDN) in 10 cases. The procedure utilizes a hand-assisted device to increase safety and control of the laparoscopic technique.

Results

Only left nephrectomy was performed. The mean total operating and the warm ischemia times were 130 minutes and 3.0 minutes, respectively. Average lengths of renal artery and vein were 1.95 cm and 2.8 cm, respectively. There were no intraoperative or postoperative complications.

Conclusions

HLDN is an easier procedure than the traditional laparoscopic living donor nephrectomy and can greatly mitigate the learning curve. HLDN has shortened warm ischemia time and operating time. It is also good for trocar placement, prevention of torsion of the kidney, control of potential bleeding at the final stage of vascular stapling, and kidney removal. Therefore, HLDN is a promising method for living donor nephrectomy.