Martina Koch1, Sylvia Kroencke2, Jun Li3, Christian Wiessner4, Björn Nashan5. 1. Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Germany; Department of General, Visceral and Transplant Surgery, Universitätsmedizin Mainz, Germany. Electronic address: martina.koch@unimedizin-mainz.de. 2. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany. 3. Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Germany. 4. Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany. 5. Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Germany; Clinic for HPB Surgery and Transplantation Center, First Affiliated Hospital, University of Science and Technology of China, Anhui, China.
Abstract
INTRODUCTION: A major goal in living donor kidney transplantation is to reduce the physical burden for the donor. Key-hole surgery for donor nephrectomy is a safe procedure, but concerns regarding donor safety during the learning phase might be the reason for surgeons' reluctance to change to a minimal invasive approach. MATERIAL AND METHODS: We analyzed the first 100 retroperitoneoscopic donor nephrectomies (RPDN) performed at our institution and compared the results to the last 50 mini incision donor nephrectomies (MIDN) regarding donor and recipient outcome, and analyzed the learning curves of RPDN. RESULTS: The learning phase of RPDN was very short with significantly shorter operative times compared to MIDN (118 vs. 175 min, p < 0.001) and significantly fewer surgical complications (p = 0.03). RPDN patients rated the physical burden (p = 0.01) as lower, and they felt less bothered by the surgical scar (p = 0.03). CONCLUSION: Introducing RPDN is safe, even during the learning phase of the surgeons. Changing surgical technique from MIDN to RPDN reduces the surgical burden of the procedure. Our study might encourage more transplant centres to adopt a minimally invasive approach.
INTRODUCTION: A major goal in living donor kidney transplantation is to reduce the physical burden for the donor. Key-hole surgery for donor nephrectomy is a safe procedure, but concerns regarding donor safety during the learning phase might be the reason for surgeons' reluctance to change to a minimal invasive approach. MATERIAL AND METHODS: We analyzed the first 100 retroperitoneoscopic donor nephrectomies (RPDN) performed at our institution and compared the results to the last 50 mini incision donor nephrectomies (MIDN) regarding donor and recipient outcome, and analyzed the learning curves of RPDN. RESULTS: The learning phase of RPDN was very short with significantly shorter operative times compared to MIDN (118 vs. 175 min, p < 0.001) and significantly fewer surgical complications (p = 0.03). RPDN patients rated the physical burden (p = 0.01) as lower, and they felt less bothered by the surgical scar (p = 0.03). CONCLUSION: Introducing RPDN is safe, even during the learning phase of the surgeons. Changing surgical technique from MIDN to RPDN reduces the surgical burden of the procedure. Our study might encourage more transplant centres to adopt a minimally invasive approach.