Hybrid technique using a Satinsky clamp for right-sided transperitoneal hand-assisted laparoscopic donor nephrectomy: comparison with left-sided standard hand-assisted laparoscopic technique.

Kim, Bum Soo; Kim, Ki Ho; Yoo, Eun Sang; Kwon, Tae Gyun

OBJECTIVE To introduce our hybrid technique using a Satinsky clamp for right-sided hand-assisted laparoscopic donor nephrectomy (HALDN) and to compare its effectiveness and safety with those of standard left-sided HALDN. METHODS We conducted a retrospective analysis of 253 patients, who underwent HALDN (51 right and 202 left) from January 2003 to December 2012. Perioperative outcomes including operative time, estimated blood loss, warm ischemic time, hospital stay, complications, and recovery of renal function in recipients were collected and compared between the right hybrid HALDN (rhHALDN) and left-sided HALDN groups. RESULTS The procedure was performed successfully in all 253 patients. No statistical difference in the mean operation time (224.3 vs 217.5 minutes), estimated blood loss (128.1 vs 123.6 mL), warm ischemic time (3.3 vs 3.1 minutes), average time to oral intake (2.4 vs 2.1 days), and mean hospital stay (4.9 vs 5.5 days) was observed between the rhHALDN and left-sided HALDN groups (P >.05). Perioperative complication rates were not statistically different between rhHALDN (2 intraoperative, 3 postoperative; 9.8%) and left-sided HALDN (6 intraoperative, 22 postoperative; 13.9%) group (P = .328). No significant difference in mean serum creatinine level and glomerular filtration rate in recipients from postoperative day 1 to 1 year was observed between the 2 groups. CONCLUSION The perioperative outcomes of rhHALDN using a Satinsky clamp were comparable with those of the left-sided standard HALDN. This hybrid technique can be a technically safe and feasible option for minimally invasive organ donation when right kidney donation is indicated.