Transvaginal Route for Kidney Extraction in Laparoscopic Donor Nephrectomy

BACKGROUND AND OBJECTIVES The aim of this retrospective study was to compare conventional laparoscopic living-donor nephrectomy with transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy in terms of feasibility and reproducibility. METHODS A total of 115 consecutive female patients who underwent laparoscopic living-donor nephrectomy (n=70) or transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy (n=45) were included and compared in terms of operative characteristics, as well as donor and recipient outcomes. RESULTS No significant difference was observed between the laparoscopic living-donor nephrectomy and transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy groups in terms of mean duration of warm and cold ischemia, operation time, length of hospital stay, arterial anastomoses, visual analog scale pain scores, serum creatinine levels, and receiver outcomes, whereas a significantly higher number of venous anastomoses was noted in the laparoscopic living-donor nephrectomy group than in the transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy group (P=.029). CONCLUSIONS Transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy seems to be a feasible and reproducible alternative to conventional laparoscopic living-donor nephrectomy in female donors provided the viability of the vagina as an organ retrieval route.