The Clinical Observation Of Hand-assisted Laparoscopic Donor Nephrectomy

Objective:To evaluate the reliability, safety and efficacy of In this article,we advance a new laparoscopic typing of hand-assisted laparoscopic donor nephrectomy(HLDN).Methods:A retrospective analysis of 7 recipients receiving living related donor kidney transplantation from one same doctor was performed. All of the 7 cases were donated by blood relationship donors. There were 1 male donor, aged 56,and 6 female donors, aged from 40 to 60. Among 7 recipients,6 were male, aged from 23 to 37, and only 1 was female, aged 17. Potential living donors underwent fully medical evaluation before operation. Donors and recipients of ABO blood type and Rh blood group are in line with the principles of blood transfusion, and all of the complement-dependent lymphocytoxicity are negative. Tripe-combined immunosuppressive protocols consisted of calcineurin inhibitors (CNI), MMF and steroid.Results:All the 7 cases underwent operations successfully. The mean operation time of HLDN was 90min, with mean hot ischemic time 90s. The mean length of renal arteries was 3.5cm, with 5cm-long renal veins on average. No surgical complications occurred. Serum creatinines(Scr) were normal (61.4umol/L-122.4umol/L).All of the 7 donors lived a normal life in a month after receiving HLDN. The recipients obtained normal Scr 2 to 5 days afer the renal transplantions. They were followed up for 3 to 11 months, with no acute or chronic rejection episodes.Conclusions:Making full use of surgical incisions and the advantage of hand, the performer of the surgery can take donor kidney in a shorter time, and avoid crush injury of the kidney. HLDN is safe and reliable, with lighter wounds, less pain, shorter operation time and hot ischemic time, and quick recovery. The blood vessels of the donor kidneys are more longer, and facilitate the renal transplantions performed later. HLDN is a minimally invasive method suitable for donor nephrectomy.