Evolution of Technique in Laparoscopic Donor Nephrectomy: A Single Center Experience.

Cintorino, Davide; Pagano, Duilio; Bonsignore, Pasquale; di Francesco, Fabrizio; Li Petri, Sergio; Ricotta, Calogero; Gruttadauria, Salvatore

BACKGROUND Renal transplantation is the most successful therapy for improving survival and quality of life for end-stage renal disease (ESRD). Living donor kidney transplantation (LDKTx) has been used as an alternative to reduce the stay on the waiting list of patients with ESRD. Laparoscopic donor nephrectomy (LDN) has become the standard procedure for LDKTx. OBJECTIVE This study aims to describe evolution of surgical technique with LDN at our institute. MATERIALS AND METHODS We retrospectively analyzed our experience with LDN performed from January, 2003 to November, 2016, focusing on describing modifications of the surgical technique and devices made during those years. Demographics, operative factors, and postoperative complications of donors were reviewed. RESULTS From the beginning of our experience with LDKTx we have performed 185 cases. From 2003 to 2016, 144 LDN were performed. Modifying our technique in response to the learning curve, complications encountered, and technological advancements, we experienced low complication rates. CONCLUSIONS Continual refinement with LDN techniques based on intraoperative observations and technological advances is necessary to keep complication rates low and reduce donor morbidity and time for recovery.