Comparison of Outcomes in Noncomplicated and in Higher-Risk Donors After Standard versus Hand-Assisted Laparoscopic Nephrectomy

Mateo, Rod B.; Sher, Linda; Jabbour, Nicolas; Singh, Gagandeep; Chan, Linda; Selby, Robert R.; El-Shahawy, Mohamed; Genyk, Yuri
September 2003
American Surgeon;Sep2003, Vol. 69 Issue 9, p771
Academic Journal
Hand-assisted techniques facilitated dissemination of the laparoscopic approach in live kidney donors and addressed concerns regarding potential procedural complications. We report our experience with both standard and hand-assisted laparoscopic nephrectomy in routine, complicated, and higher-risk donors. From July 1999 to September 2002, 47 donors underwent standard laparoscopic donor nephrectomy (SLDN; n = 29) or hand-assisted laparoscopic donor nephrectomy (HALDN; n = 18). Donors were "complicated" if they were >60 years of age, obese, refused blood-product transfusion, had multiple renal arteries or veins, or had right nephrectomies. "Higher-risk" donors had two or more risk factors. Results for SLDN and HALDN were compared for the overall groups and for the "complicated" and "higher-risk" groups. No donor required blood transfusion or reoperation. Warm-ischemia times were shorter in left nephrectomies (191± 72 seconds vs. 337 ± 95 seconds, P = 0.005), and blood loss was greater in patients with a body mass index ≥30 kg/m² (296 ± 232 mL vs. 170± 139 mL, P = 0.03). Higher-risk donors had an increased operative blood loss and longer hospital stay than low-risk donors. Mean donor creatinine at discharge was 1.19 ± 0.2 mg/dL. Comparison of SLDN versus HALDN revealed shorter operating times for the latter, which approached statistical significance. Warm-ischemia time, operative blood loss, length of hospitalization, and donor and recipient discharge creatinines were similar for both groups. Laparoscopic donor...


Related Articles

  • Donor Complications Following Laparoscopic Compared to Hand-Assisted Living Donor Nephrectomy: An Analysis of the Literature. Halgrimson, Whitney R.; Campsen, Jeffrey; Mandell, M. Susan; Kelly, Mara A.; Kam, Igal; Zimmerman, Michael A. // Journal of Transplantation;2010, p1 

    There are two approaches to laparoscopic donor nephrectomy: standard laparoscopic donor nephrectomy (LDN) and handassisted laparoscopic donor nephrectomy (HALDN). In this study we report the operative statistics and donor complications associated with LDN and HALDN from large-center...

  • El tiempo de isquemia fría corto optimiza los resultados de los trasplantes renales efectuados con donantes con criterios expandidos. Gallego Valcare, E.; Ortega Cerrato, A.; Llamas Fuentes, F.; Masiá Mondéjar, J.; Martínez Fernández, G.; López Rubio, E.; López Montes, A.; Pérez Martínez, J.; Martínez Villaescusa, M.; Gómez Roldán, C. // Nefrologia;Nov2009, Vol. 29 Issue 5, p456 

    Introduction: Outcome of renal transplant from expanded criteria donors (ECD) is usually inferior than those from standard criteria donors (SCD) and may be improved decreasing cold ischemia time (CIT) and minimizing preservation injury. We compare the results obtained with CIT <15 hours in...

  • Warm ischemia time does not correlate with recipient graft function in laparoscopic donor nephrectomy. Buzdon, M. M.; Cho, E.; Jacobs, S. C.; Jarrell, B.; Flowers, J. L. // Surgical Endoscopy;May2003, Vol. 17 Issue 5, p746 

    Background: Laparoscopic donor nephrectomy (LDN) has been shown to be a safe and effective option for renal procurement. Studies comparing open nephrectomy and hand-assisted laparoscopy have emphasized decreased warm ischemia time when compared with “pure” laparoscopic retrieval....

  • 15: Laparoscopic Donor Nephrectomy: Experience from a Tertiary care centre. Minz, Mukut; Sharma, Ashish; Mavuduru, Ravimohan; Bhuvanesh, P.; Mandal, Arup K.; Agarwal, Mayank M.; Acharya, Naveen; Singh, Shrawan K. // Indian Journal of Urology;Supplement2, Vol. 24, pS61 

    Introduction: To evaluate our experience for live donor Nephrectomy with respect to donor safety and graft function. Methods: All the donor nephrectomies were included from June 2004 and Jan 2008. The data regarding operative time, intraoperative complications, the warm ischemia time, and the...

  • Short learning curve seen for LESS donor nephrectomy. Overmyer, Mac // Urology Times;Apr2012, Vol. 40 Issue 4, p22 

    The article reports on the studies regarding laparoscopic single-site (LESS) donor nephrectomy. It says that the studies suggest that learning curve is short for the experienced laparoscopic surgeons and patients with multiple renal arteries need not to be part for the technique. According to...

  • Comparación entre nefrectomía abierta y la nefrectomía laparoscópica mano asistida en pacientes donadores vivos relacionados. Cárdenas, Fernando Juárez; Ramírez, José Carlos Vizcaíno; García, Román Carvajal; González, Andrés Fernández; Arce, Jorge Montes de Oca // Boletin del Colegio Mexicano de Urologia;sep-dic2006, Vol. 21 Issue 3, p92 

    Objective: The objective of this study is to demonstrate our initial experience with hand assisted laparoscopic nephrectomy for alive related donors renal transplant in Regional Hospital Valentin Gomez Farias. Material and methods: A retrospective study was made reviewing files of related alive...

  • A Decade of Laparoscopic Appendectomy: Presentation of 1026 Patients with Suspected Appendicitis Treated in a Single Surgical Department. Konstantinidis, Konstantinos M.; Anastasakou, Kornilia A.; Vorias, Michael N.; Sambalis, George H.; Georgiou, Michael K.; Xiarchos, Anastasios G. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr2008, Vol. 18 Issue 2, p248 

    Background: The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Nevertheless, the discussion on its safety, efficacy, indications, and diagnostic accuracy remains open. Methods: During the decade 19932003, 1026 patients with suspected appendicitis were...

  • Long-term results from laparoscopic common bile duct exploration. Waage, A.; Strömberg, C.; Leijonmarck, C.-E.; Arvidsson, D.; Strömberg, C // Surgical Endoscopy;Aug2003, Vol. 17 Issue 8, p1181 

    Background: The aim of this study was to evaluate the long-term results after laparoscopic common bile duct exploration (LCBDE).Methods: A retrospective review of 175 consecutive patients who underwent attempted LCBDE between 1992 and 1999 was conducted. Laparoscopic...

  • Combining ultrasonic dissection and the Storz operation rectoscope. Lirici, M.M.; Paola, M.; Ponzano, C.; Hüscher, C.G.S.; Di Paola, M; Hüscher, C G S // Surgical Endoscopy;Aug2003, Vol. 17 Issue 8, p1292 

    Background: Transanal endoscopic microsurgery (TEM) allows a precise, full-thickness resection of rectal tumors anywhere within the rectum. Unfortunately, the standard TEM technique needs complex and rather expensive equipment, demands high skill, and is attended by bleeding and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics