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Surg Endosc. 2010 Nov;24(11):2755-9. doi: 10.1007/s00464-010-1040-z. Epub 2010 Apr 10.

The feasibility of solo-surgeon living donor nephrectomy: initial experience using video-assisted minilaparotomy surgery.

Author information

1
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea. asforthelord@yuhs.ac

Abstract

BACKGROUND:

Today, many kinds of surgery are being conducted without human assistants. Living donor nephrectomy (LDN) using video-assisted minilaparotomy surgery (VAM) has been performed by solo-surgeon using Unitrac® (Aesculap Surgical Instrument, Germany). We examined the results from VAM-solo-surgeon living donor nephrectomy (SLDN) and conventional VAM-human-assisted living donor nephrectomy (HLDN).

METHODS:

Between July 2007 and April 2008, 82 cases of VAM-LDN were performed by two surgeons. From these cases, we randomly assigned 35 cases to undergo solo-surgery (group I) and the other 47 cases to undergo surgery with one human assistant (group II). All VAM-LDN procedures were performed in the same manner. Only the roles of a first assistant were substituted by the Unitrac® in group I. We compared the perioperative and postoperative data, including operative time, estimated blood loss, and hospital stay, between the two groups. We also investigated cases that developed complications.

RESULTS:

There were no significant differences in the patient demographic data between the two groups (P > 0.05). The mean operative time was 201.9 ± 32.9 min in group I and 202.4 ± 48.3 min in group II (P = 0.954), whereas mean blood loss was 209.7 ± 167.3 ml in group I and 179.6 ± 87.8 ml in group II (P = 0.294). Postoperative hospital stay were 5.4 ± 1.1 days in group I and 5.5 ± 1.6 days in group II (P = 0.813). The incidence of perioperative complications was not significantly different between the two groups.

CONCLUSIONS:

Our study demonstrates that VAM-SLDN can be performed safely, is economically beneficial, and is comparable to VAM-HLDN in terms of postoperative outcomes.

PMID:
20383533
DOI:
10.1007/s00464-010-1040-z
[Indexed for MEDLINE]

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