28 February 2013
Program of laparoscopic living-donor nephrectomy with retroperitoneoscopic access – a Polish single-center experience – success or disappointment?Marcin SłojewskiABCDEFG, Marek MyślakAB, Leszek DomańskiABD, Krzysztof PabisiakABF, Agata JasiczekABF, Tadeusz SulikowskiBFG, Jerzy SieńkoBCDG, Kazimierz CiechanowskiABDF, Marek OstrowskiABDG, Andrzej SikorskiAEG
Ann Transplant 2013; 18:82-87
BACKGROUND: Laparoscopic living-donor nephrectomy (LLDN) is an attractive alternative to open approach and is a widely accepted method of kidney retrieval for transplantation. Here, we present the first Polish series of LLDN performed at a single center.
MATERIAL AND METHODS: Between April 2008 and May 2012, we performed 8 LLDN with an immediate renal transplantation using classical surgical approach and technique. Four men and 4 women were operated on. In all cases of LLDN, left kidneys were retrieved and retroperitoneal approach with 3 trocars was used according to the technique we described previously.
RESULTS: No intra- or postoperative complications were observed. The average “skin-to-skin” time of surgery was 138 minutes (min. 80; max. 210). The blood loss ranged from 0 to 280 ml (average, 80). Warm ischemia time did not exceed 3 minutes in any case. All organs were immediately implanted in the second operating room. Postoperative course was uneventful in all donors and recipients.
CONCLUSIONS: Similar to many authors, at the beginning of our program we hoped that introduction of LLDN would increase the donor pool in Poland. Unfortunately, so far, these expectations have not been realized. However, we consider our program as a success regarding multidisciplinary cooperation and feasibility of LLDN in our country.
Keywords: Kidney Transplantation, laparoscopic surgery , laparoscopic living-donor nephrectomy
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