V1729: Laparoscopic Living Donor Nephrectomy with the use of 3 mm instruments and laparoscope
VideoIntroduction and Objectives
Laparoscopy has become the standard of care for kidney retrieval during laparoscopic live donor nephrectomy (LLDN). In the donor population the cosmetic results are of great importance and multiple minimal invasive techniques have been developed. While robotic surgery has not gain in popularity in the LLDN population, single port surgery is becoming very attractive, even if technically challenging. On the contrary, needlescopic surgery may offer advantages over single port surgery due to the fact that it reproduces the standard principle of laparoscopy while minimizing the incision size. In this video we present our experience with LLDN with the use of 3 mm instruments and laparoscope.
Between Nov 2010 and Oct 2012 all potential donors with a BMI
7 LLDN were performed with this technique (4 M and 3F). The avarage age was 42 and the mean BMI was 25. Left LLDN was performed in all cases. Two donors had two arteries and a retroaortic vein. The other 4 donors had single artery and vein. Mean operative time was 164 minutes and mean warm ischemia time was 2.9 minutes. There were no intraopertive and postoperative major complications although one donor developed a subcutaneous seroma that was managed conservatively. All patients were satisfied with their cosmetic results as documented by the low score on the Patient Scar Assessment Questionnaire and Scoring System (PSAQ).
LLDN with the use of 3 mm instruments appears to be reproducible and safe since it preserves the general principle of laparoscopy while minimizing the incision size. We hope that this small study will serve as preliminary data for further investigation in the field of needlescopic surgery in LLDN.