OBJECTIVE: To compare the anatomy and function of right and left kidneys retrieved by laparoscopic live donor nephrectomy (LDN). PATIENTS AND METHODS: In all, 84 transperitoneal LDNs were performed, 66 left and 18 right. Two different right-sided LDN techniques were used: initially, the inferior vena cava (IVC) was controlled with a Satinsky clamp introduced through a 6-8 cm right upper quadrant incision, through which the kidney was also removed (six patients). Subsequently, the IVC was completely mobilized by laparoscopic retrocaval dissection (in 12 patients), allowing the use of a linear stapler-cutter, including the caval ostium with the renal vein. The kidney was then removed through a short Pfannenstiel incision. RESULTS: Left kidneys had longer renal veins (38 vs 27 mm; P < 0.05), but there were no differences in arterial length (32 vs 31 mm). Three right kidneys required back-table renal vein lengthening. The operative duration was shorter for right-sided LDNs (132 vs 182 min; P < 0.05). The serum creatinine level at 3 months was 131 vs 134 mmol/L for right and left kidneys, respectively. CONCLUSIONS: Despite faster surgery suggesting that the right LDN is technically easier, there is a greater need for back-table reconstruction of the renal vein. The functional results of right and left kidneys are equivalent.
OBJECTIVE: To compare the anatomy and function of right and left kidneys retrieved by laparoscopic live donor nephrectomy (LDN). PATIENTS AND METHODS: In all, 84 transperitoneal LDNs were performed, 66 left and 18 right. Two different right-sided LDN techniques were used: initially, the inferior vena cava (IVC) was controlled with a Satinsky clamp introduced through a 6-8 cm right upper quadrant incision, through which the kidney was also removed (six patients). Subsequently, the IVC was completely mobilized by laparoscopic retrocaval dissection (in 12 patients), allowing the use of a linear stapler-cutter, including the caval ostium with the renal vein. The kidney was then removed through a short Pfannenstiel incision. RESULTS:Left kidneys had longer renal veins (38 vs 27 mm; P < 0.05), but there were no differences in arterial length (32 vs 31 mm). Three right kidneys required back-table renal vein lengthening. The operative duration was shorter for right-sided LDNs (132 vs 182 min; P < 0.05). The serum creatinine level at 3 months was 131 vs 134 mmol/L for right and left kidneys, respectively. CONCLUSIONS: Despite faster surgery suggesting that the right LDN is technically easier, there is a greater need for back-table reconstruction of the renal vein. The functional results of right and left kidneys are equivalent.
Authors: John Fitzpatrick; Jakub Chmelo; Arjun Nambiar; Oliver Fuge; Toby Page; Gourab Sen; Naeem Soomro; David Rix; Alistair Rogers; David Talbot; Rajan Veeratterapillay Journal: Urol Ann Date: 2020-07-17
Authors: Mark Sawatzky; Abdulmalik Altaf; James Ellsmere; Dennis Klassen; Mark Walsh; Michele Molinari; Björn Nashan; Jaap Bonjer Journal: Surg Endosc Date: 2008-09-24 Impact factor: 4.584
Authors: Ellen L K Dobrijevic; Eric H K Au; Natasha M Rogers; Philip A Clayton; Germaine Wong; Richard D M Allen Journal: Transpl Int Date: 2022-04-04 Impact factor: 3.842