Laparoscopic and Robotic Urology
Techniques in laparoscopic donor nephrectomy
Version of Record online: 10 APR 2012
© 2012 BJU INTERNATIONAL
Volume 110, Issue 9, pages 1368–1373, November 2012
How to Cite
Banga, N. and Nicol, D. (2012), Techniques in laparoscopic donor nephrectomy. BJU International, 110: 1368–1373. doi: 10.1111/j.1464-410X.2012.11058.x
- Issue online: 16 OCT 2012
- Version of Record online: 10 APR 2012
- Accepted for publication 10 November 2011
- laparoscopic donor nephrectomy;
- hand-assisted donor nephrectomy;
- retroperitoneoscopic donor nephrectomy;
- robot-assisted donor nephrectomy
What's known on the subject? and What does the study add?
Innovations in laparoscopic surgery have provided transplant surgeons with a range of techniques as well as a vast array of minimally invasive instruments. Whilst randomized control trials have compared open and laparoscopic donor nephrectomy, there is a paucity of high quality data comparing different laparoscopic approaches. This article summarizes the main techniques of laparoscopic donor nephrectomy currently in use and reviews the evidence available for each. In addition, controversial aspects of donor nephrectomy are examined, including the technological advances applicable to this operation.
Increasing numbers of living donor kidney transplants are being performed worldwide, and the majority of donor operations are now laparoscopic. Transperitoneal ‘pure’ and hand-assisted laparoscopic donor nephrectomy are the two most commonly performed procedures, although retroperitoneal approaches are advocated by some centres. Controversy persists with respect to the technical aspects of donor nephrectomy, including both the approach and the method of ligation of the hilar vessels. More recently, robot-assisted, laparo-endoscopic single site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) -assisted donor nephrectomy have also been performed, further increasing the number of options available, but creating uncertainty as to the ideal approach.