Laparoscopic nephrectomy: Safe and comfortable surgical alternative for living donors and for good results of graft function

Abstract

Laparoscopic nephrectomy for kidney donation from living related donors has the advantages of a less invasive surgical access, better cosmesis, and a shorter hospital stay for the donor. However, some workers have reported up to 10% life-threatening complications for the donor using this technique. The purpose of our study was to evaluate hand-assisted laparoscopic nephrectomy for living donors of kidney transplants in terms of graft function. Thirty donors who underwent open nephrectomy (ON) were compared with 27 who had hand-assisted nephrectomy (HALN). Surgery and ischemia times, hospital stay, bleeding, graft function, remaining kidney function, and complications were compared in both groups. Mean surgery time was 126.9 minutes for ON and 98 minutes for HALN (P = .0005), warm ischemia time was 3 minutes versus 6 for ON vs HALN, respectively (P = .02). Hospitalization stay was 6.3 days for ON versus 4.8 days for HALN (P = .0015). Differences in change in hematocrit and in serum creatinine levels were not significant; graft outcomes were also similar. Complications were minimal. We conclude that HALN is a valid, safe technique to obtain kidneys from living related donors, significantly reducing the hospital stay and allowing return to normal activities sooner, with risks falling within those reported in the literature.