Hand-assisted laparoscopic living-donor nephrectomy as an alternative to traditional laparoscopic living-donor nephrectomy

Academic Article

Abstract

  • The benefits of laparoscopic living-donor nephrectomy (LDN) are well described, while similar data on hand-assisted laparoscopic living-donor nephrectomy (HALDN) are lacking. We compare hand-assisted laparoscopic living-donor nephrectomy with open donor nephrectomy. One hundred consecutive hand-assisted laparoscopic living-donor nephrectomy (10/98-8/01) donor/recipient pairs were compared to 50 open donor nephrectomy pairs (8/97-1/00). Mean donor weights were similar (179.6 ± 40.8 vs. 167.4 ± 30.3 lb; p = NS), while donor age was greater among hand-assisted laparoscopic living-donor nephrectomy (38.2 ± 9.5 vs. 31.2 ± 7.8year; p <0.01). Right nephrectomies was fewer in hand-assisted laparoscopic living-donor nephrectomy [17/100 (17%) vs. 22/50 (44%); p <0.05]. Operative time for hand-assisted laparoscopic living-donor nephrectomy (3.9±0.7 vs. 2.9±0.5 h; p <0.01) was longer; however, return to diet (6.9±2.8 vs. 25.6±6.1 h; p <0.01), narcotics requirement (17.9±6.3 vs. 56.3±6.4 h; p <0.01) and length of stay (51.7±22.2 vs. 129.6±65.7 h; p <0.01) were less than open donor nephrectomy. Costs were similar ($11 072 vs. 10 840). Graft function and 1-week Cr of 1.4±0.9 vs. 1.6±1.1 g/dL (p = NS) were similar. With the introduction of HALDN, our laparoscopic living-donor nephrectomy program has increased by 20%. Thus, similar to traditional laparoscopic donor nephrectomy, hand-assisted laparoscopic living-donor nephrectomy provides advantages over open donor nephrectomy without increasing costs.
  • Authors

    Published In

    Digital Object Identifier (doi)

    Author List

  • Buell JF; Hanaway MJ; Potter SR; Cronin DC; Yoshida A; Munda R; Alexander JW; Newell KA; Bruce DS; Woodle ES
  • Start Page

  • 983
  • End Page

  • 988
  • Volume

  • 2
  • Issue

  • 10