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J Endourol. 2004 Apr;18(3):221-5; discussion 225.

Pure laparoscopic right donor nephrectomy: step-by-step approach.

Author information

1
Department of Urology, University of California School of Medicine, San Francisco, California 94143-0738, USA. habahams@urol.ucsf.edu

Abstract

BACKGROUND AND PURPOSE:

Debate surrounds laparoscopic kidney procurement for right donor nephrectomy. We detail our pure laparoscopic technique of right kidney retrieval.

TECHNIQUE:

We use a four-port transperitoneal approach and extract the kidney through a low Pfannenstiel incision. Important elements include: (1) dividing the triangular ligament; (2) identifying the vena cava early; (3) minimizing ureteral dissection; (4) mobilizing the kidney within Gerota's fascia; (5) dissecting the renal artery behind the vena cava; (6) cutting the extraction incision to the peritoneum; (7) applying a Hem-o-Lok and single metal clip on the artery; (8) placing the Endo-TA stapler on the renal vein adjacent to the vena cava; (9) cutting the vessels without clips/staples on the kidney side; and (10) retrieving the kidney manually.

RESULTS AND CONCLUSIONS:

This is a reliable method of right pure laparoscopic donor nephrectomy that maximizes donor benefit and cost-effectiveness. Right laparoscopic nephrectomy is likely easier with this technique and should not be avoided if it is the preferred kidney for transplantation.

PMID:
15225384
DOI:
10.1089/089277904773582796
[Indexed for MEDLINE]

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