BACKGROUND: Laparoscopic live donor nephrectomy (LLDN) has become the standard of care and is popular among most of the transplant centers across the globe. Despite proven advantages of LLDN, some transplantation centers hesitate to start the program because of issues concerning donor safety and allograft function. OBJECTIVE: To discusses the main barriers for creating a successful LLDN program, strategies that allowed us to start a successful LLDN program along with the study results. METHODS: The donors undergoing LLDN from December 2016 to February 2018 were enrolled in the study and prospectively evaluated. LLDN were performed by two senior surgeons alternately with assistance by the laparoscopic urologist in all cases. Also, in the present study, two technical alterations were done in the standard surgical technique of transperitoneal LDN. The first important modification made was the use of two additional ports for use by laparoscopic urologists. The second modification involved dissection on both poles of the kidney before hilar dissection. RESULTS: A total of 112 transperitoneal LLDN were performed during the study period. The mean (range) of operation time was 117.5 (81-158) min; the ischemia time was 194 (171-553) sec. Only one patient needed conversion to open surgery. No other major peri-operative or posto-perative complications occurred. All kidney grafts were functioning well. CONCLUSION: With proper planning, team approach, and few technical modifications, introduction of LLDN is safe and effective.
BACKGROUND: Laparoscopic live donor nephrectomy (LLDN) has become the standard of care and is popular among most of the transplant centers across the globe. Despite proven advantages of LLDN, some transplantation centers hesitate to start the program because of issues concerning donor safety and allograft function. OBJECTIVE: To discusses the main barriers for creating a successful LLDN program, strategies that allowed us to start a successful LLDN program along with the study results. METHODS: The donors undergoing LLDN from December 2016 to February 2018 were enrolled in the study and prospectively evaluated. LLDN were performed by two senior surgeons alternately with assistance by the laparoscopic urologist in all cases. Also, in the present study, two technical alterations were done in the standard surgical technique of transperitoneal LDN. The first important modification made was the use of two additional ports for use by laparoscopic urologists. The second modification involved dissection on both poles of the kidney before hilar dissection. RESULTS: A total of 112 transperitoneal LLDN were performed during the study period. The mean (range) of operation time was 117.5 (81-158) min; the ischemia time was 194 (171-553) sec. Only one patient needed conversion to open surgery. No other major peri-operative or posto-perative complications occurred. All kidney grafts were functioning well. CONCLUSION: With proper planning, team approach, and few technical modifications, introduction of LLDN is safe and effective.
Authors: N Simforoosh; A Bassiri; S A M Ziaee; A Tabibi; N S Salim; F Pourrezagholi; S M M H Moghaddam; R Maghsoodi; H Shafi Journal: Transplant Proc Date: 2003-11 Impact factor: 1.066
Authors: Renaud Bollens; Dimitri Mikhaski; Baldo P Espinoza; Alberto Rosenblatt; Anh Dung Hoang; Daniel Abramowicz; Vincent Donckier; Claude C Schulman Journal: Eur Urol Date: 2006-12-05 Impact factor: 20.096
Authors: D Nunes-Carneiro; A Marques-Pinto; C Veiga; I Braga; J F Cabral; M Almeida; V Cavadas; A Castro-Henriques; R Almeida; A Fraga; M Silva-Ramos Journal: Transplant Proc Date: 2019-01-21 Impact factor: 1.066
Authors: Nasser Simforoosh; Reza Sarhangnejad; Abbas Basiri; Seyed Amir Mohsen Ziaee; Farzaneh Sharifiaghdas; Ali Tabibi; Akbar Nouralizadeh; Amir H Kashi; Nadali Moosanejad Journal: J Endourol Date: 2012-04-16 Impact factor: 2.942
Authors: Lee Ponsky; Edward Cherullo; Alireza Moinzadeh; Mihir Desai; Jihad Kaouk; Georges-Pascal Haber; David Chen; Christopher Ng; Gerhard Fuchs; Dinesh Singh; Antonio Finelli; Igor Frank; Surena Matin Journal: Urology Date: 2008-03-04 Impact factor: 2.649