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Arch Esp Urol. 2012 Apr;65(3):318-28.

Laparo-endoscopic single-site donor nephrectomy: techniques and outcomes.

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  • 1Section of Laparoscopic and Robotic Surgery, USC Institute of Urology, University of Southern California, Los Angeles, CA 90033, USA.



Living donor nephrectomy is a unique surgical procedure in urological practice and must optimize the trifecta of: patient safety, minimal morbidity and successful graft function. The laparoscopic technique has become the gold standard over the last decade for harvesting the kidney from a living donor. Laparo-endoscopic single-site (LESS) surgery is an attempt to further enhance cosmetic benefits and reduce the morbidity for potential kidney donors. We have summarized and reviewed the literature of LESS-DN and described the techniques and outcomes.


Using the National Library of Medicine database, the English language literature was reviewed from 2006 to 2011. Keyword searches included LESS, Donor, Nephrectomy, Living, Single-site, e-NOTES, Mini-invasive, Laparoscopic, Single-port. Within the bibliography of selected references, additional sources were retrieved.


After Gill's description of the first four patients to undergo LESS-DN, we found five series published describing the surgical techniques of LESS-DN as well as the outcomes. We have outlined in detail the various techniques of the trans-umbilical LESS-DN and compared the outcomes with conventional LDN. We also briefly discuss new innovative techniques of LESS-DN.


LESS-DN is a safe albeit technically challenging alternative to LDN. LESS-DN appears to have comparable results to LDN in terms of graft function, patient morbidity, and cosmesis. Further long term results and the development in parallel with other LESS procedures is required before LESS-DN is to be considered a standard of care.

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