OBJECTIVE: Minimally invasive techniques have expanded the donor pool for living kidney donation. We changed our approach to single-port donor nephrectomy in 2009 and have compared outcomes with traditional multiple-port laparoscopic donor nephrectomy. BACKGROUND: The development of minimally invasive surgical techniques to procure kidneys from living donors has allowed expansion of living donor renal transplantation to account for one third of all renal transplants. Recent technical advancement allows for the entire surgical procedure to be done through a single incision contained within the umbilicus. METHODS: We compared outcomes from 135 single-port donor nephrectomies with an immediately preceding cohort of 100 multiple-port laparoscopic donor nephrectomies. Survey data were collected from both groups to compare outcomes. Additional comparisons were made to total center experience with 1300 laparoscopic donor nephrectomies. RESULTS: A total of 135 patients completed successful single-port donor nephrectomy without major complication or open conversion. Another 16 patients required additional port placement because of excessive intra-abdominal fat or limited abdominal domain. Compared with multiple-port donor nephrectomy, single-port patients had similar operative times to cross clamp (2.8 vs 2.6 hours; P = 0.11) that normalized after a learning curve of approximately 50 cases. Recipient creatinine levels were similar at 1 week and 1 month posttransplant. Although 36-Item Short Form Health Surveys demonstrated no significant differences, additional survey data revealed that single-port patients were more satisfied with cosmetic outcomes (P < 0.01) and the overall donation process (P = 0.01). Single-port approach had similar outcomes compared with all previous laparoscopic donor nephrectomies. CONCLUSIONS: Single-port donor nephrectomy can be integrated as a standardized approach for renal donation without additional donor risk, and with benefits of improved patient satisfaction with cosmetic and overall outcomes. Although the primary benefit is cosmetic, (a single incision predominantly contained within the umbilicus) outcomes justify application for kidney donors in experienced centers and may motivate additional living kidney donation.
OBJECTIVE: Minimally invasive techniques have expanded the donor pool for living kidney donation. We changed our approach to single-port donor nephrectomy in 2009 and have compared outcomes with traditional multiple-port laparoscopic donor nephrectomy. BACKGROUND: The development of minimally invasive surgical techniques to procure kidneys from living donors has allowed expansion of living donor renal transplantation to account for one third of all renal transplants. Recent technical advancement allows for the entire surgical procedure to be done through a single incision contained within the umbilicus. METHODS: We compared outcomes from 135 single-port donor nephrectomies with an immediately preceding cohort of 100 multiple-port laparoscopic donor nephrectomies. Survey data were collected from both groups to compare outcomes. Additional comparisons were made to total center experience with 1300 laparoscopic donor nephrectomies. RESULTS: A total of 135 patients completed successful single-port donor nephrectomy without major complication or open conversion. Another 16 patients required additional port placement because of excessive intra-abdominal fat or limited abdominal domain. Compared with multiple-port donor nephrectomy, single-port patients had similar operative times to cross clamp (2.8 vs 2.6 hours; P = 0.11) that normalized after a learning curve of approximately 50 cases. Recipient creatinine levels were similar at 1 week and 1 month posttransplant. Although 36-Item Short Form Health Surveys demonstrated no significant differences, additional survey data revealed that single-port patients were more satisfied with cosmetic outcomes (P < 0.01) and the overall donation process (P = 0.01). Single-port approach had similar outcomes compared with all previous laparoscopic donor nephrectomies. CONCLUSIONS: Single-port donor nephrectomy can be integrated as a standardized approach for renal donation without additional donor risk, and with benefits of improved patient satisfaction with cosmetic and overall outcomes. Although the primary benefit is cosmetic, (a single incision predominantly contained within the umbilicus) outcomes justify application for kidney donors in experienced centers and may motivate additional living kidney donation.
Authors: Ryan W Dobbs; Whitney R Halgrimson; Susan Talamini; Hari T Vigneswaran; Jessica O Wilson; Simone Crivellaro Journal: World J Urol Date: 2019-08-28 Impact factor: 4.226
Authors: Nicole M Shockcor; Sam Sultan; Josue Alvarez-Casas; Philip S Brazio; Michael Phelan; John C LaMattina; Rolf N Barth Journal: Langenbecks Arch Surg Date: 2018-08-21 Impact factor: 3.445
Authors: M J Aull; C Afaneh; M Charlton; D Serur; M Douglas; P J Christos; S Kapur; J J Del Pizzo Journal: Am J Transplant Date: 2014-06-16 Impact factor: 8.086
Authors: Joo Mee Kim; Won Jun Jeong; Byung Jo Choi; Seung Mo Yuk; Jeong Kye Hwang; Sang Chul Lee Journal: Ann Surg Treat Res Date: 2015-10-28 Impact factor: 1.859
Authors: Sarwat B Ahmad; Brian Inouye; Michael S Phelan; Andrew C Kramer; Jay Sulek; Matthew R Weir; Rolf N Barth; John C LaMattina; Eugene J Schweitzer; David B Leeser; Silke V Niederhaus; Stephen T Bartlett; Jonathan S Bromberg Journal: Transplantation Date: 2016-02 Impact factor: 4.939
Authors: Denise M D Özdemir-van Brunschot; Giel G Koning; Kees C J H M van Laarhoven; Mehmet Ergün; Sharon B C E van Horne; Maroeska M Rovers; Michiel C Warlé Journal: PLoS One Date: 2015-03-27 Impact factor: 3.240
Authors: Won Jun Jeong; Byung Jo Choi; Jeong Kye Hwang; Seung Mo Yuk; Min Jong Song; Sang Chul Lee Journal: Ann Surg Treat Res Date: 2015-01-28 Impact factor: 1.859