Laparoscopic donor nephrectomy
نویسندگان
چکیده
Of the various options for patients with end stage renal disease, kidney transplantation is the treatment of choice for a suitable patient. The kidney for transplantation is retrieved from either a cadaver or a live donor. Living donor nephrectomy has been developed as a method to address the shortfall in cadaveric kidneys available for transplantation. Laparoscopic living donor nephrectomy (LLDN), by reducing postoperative pain, shortening convalescence, and improving the cosmetic outcome of the donor nephrectomy, has shown the potential to increase the number of living kidney donations further by removing some of the disincentives inherent to donation itself. The technique of LLDN has undergone evolution at different transplant centers and many modifications have been done to improve donor safety and recipient outcome. Virtually all donors eligible for an open surgical procedure may also undergo the laparoscopic operation. Various earlier contraindications to LDN, such as right donor kidney, multiple vessels, anomalous vasculature and obesity have been overcome with increasing experience. Laparoscopic live donor nephrectomy can be done transperitoneally or retroperitoneally on either side. The approach is most commonly transperitoneal, which allows adequate working space and easy dissection. A review of literature and our experience with regards to standard approach and the modifications is presented including a cost saving model for the developing countries. An assessment has been made, of the impact of LDN on the outcome of donor and the recipient.
منابع مشابه
مقایسه کارکرد کلیه پیوندی یک سال پس از عمل بین نفرکتومی دهنده به روش باز و لاپاراسکوپیک
Background and purpose: Laparoscopic donor nephrectomy is an appropriate alternative for open donor nephrectomy in kidney transplant. The latter has been applied in most health centers for 50 years and it has been proven that unilateral nephrechtomy (laparotomy) is safe for the doner and so the remaining kidney can handle its function well. Since the former method for the kidney doner has been ...
متن کاملEvaluation of right versus left laparoscopic donor nephrectomy.
OBJECTIVES With the advent of laparoscopic donor nephrectomy, there has been a general underuse of right laparoscopic donor nephrectomy versus left because of concerns regarding higher complication rates and poorer outcomes. We performed a retrospective analysis of our laparoscopic donor nephrectomy series with an emphasis on the side of the kidney retrieved and the outcomes of donors and recip...
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PURPOSE To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy. METHODS In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses w...
متن کاملComparison between laparoscopic and subcostal mini- incision for live donor nephrectomy Comparação entre a nefrectomia laparoscópica e a nefrectomia subcostal como acessos cirúrgicos para nefrectomia do doador
Objectives: The aim of this study was to compare the results of laparoscopic donor nephrectomy with open donor nephrectomy. Methods: A non-randomized prospective analysis was conducted of living donor kidney transplantations (118 open donor nephrectomies; 57 laparoscopic donor nephrectomies) between January 2005 and December 2007 in the Kidney Transplantation Unit of Hospital das Clínicas of Fa...
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PURPOSE A review of the existing literature showed that the subject of live donor nephrectomy is a seat of underreporting and underestimation of complications. We provide a systematic comparison between laparoscopic and open live donor nephrectomy with special emphasis on the safety of donors and grafts. MATERIALS AND METHODS The PubMed literature database was searched from inception to Octob...
متن کاملSurgical techniques in living donor nephrectomy
• Donor mortality and major complications appear equivalent with laparoscopic and open donor nephrectomy. In open surgery, the risks appear related to perioperative complications including pulmonary emboli, pneumonia and ischaemic events. With laparoscopic surgery, complications are largely due to catastrophic intraoperative events related to securing of the vascular pedicle. Measures to reduce...
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