Transition from transperitoneal to retroperitoneal approach in laparoscopic living donor nephrectomy: team-based and individual learning curve: a cross-sectional study

Background: Laparoscopic living donor nephrectomy (LLDN) is a standard practice for kidney transplantation due to fewer complications associated with the treatment. Retroperitoneal approach LLDN thought be more advantageous in preventing injuries various abdominal organs. However, transition process from transperitoneal retroperitoneal important ensure best outcome patients. The aim of this study was to investigate learning curve among urologists an individual and team-based approach Methods: A retrospective analysis was performed on procedures by team consisting four January 2019 2022 at Cipto Mangunkusumo National General Hospital, Indonesia. data were taken pre-existing medical records. operation time, warm ischemic estimated blood loss analyzed using cumulative sum (CUSUM) analysis. Phase 1 represents initial curve, phase 2 plateau period proficiency, while 3 mastery period. Results: total 127 done during operators experience. average procedure needed achieve proficiency 16.5 procedures. Meanwhile, 28 Shorter achieved experience other laparoscopic procedures. Conclusions: The relatively short feasible both individuals teams urologists. Therefore, option reduce complication rate LLDN.