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ORIGINAL ARTICLE
Year : 2011  |  Volume : 27  |  Issue : 2  |  Page : 180-184

Transumbilical laparoendoscopic single-site donor nephrectomy: Without the use of a single port access device


Department of Urology and Surgical Gastro-enterology, Manipal Hospital, Airport Road, Bangalore, India

Correspondence Address:
Deepak Dubey
Consultant in Urology and Renal transplantation, Manipal Hospital, Airport Road, Bangalore-560037
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.82834

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Introduction : Laparoendoscopic single-site donor nephrectomy (LESS-DN) is a procedure in evolution. Currently described techniques utilize single port access devices and articulating, flexible, and bent working instruments. We describe a modified technique of transumbilical LESS-DN with conventional laparoscopic instruments in five kidney donors. Materials and Methods : Three standard laparoscopic ports (10 mm x 1, 5 mm x 2) were placed through a 4.5 cm vertical transumbilical incision. A 10 mm 45°, long bariatric lens (Karl Storz) was used. Renal mobilization was performed using conventional rigid laparoscopy instruments. A port closure needle loaded with a blunt plastic needle cap was used for traction. After hilar clamping, an incision was made connecting the three ports, and the kidney was extracted using a preplaced suture over the lower pole fat. All data were prospectively recorded. Results : LESS-DN was performed successfully in all five patients. The mean operative time was 157.2 minutes (range, 134-184) and the mean warm ischemia time was 3.2 minutes (range, 3-4). All donors were discharged on postoperative day 3 and were able to resume normal physical activity by 2 weeks after the procedure. All donors had an excellent cosmetic outcome. The mean serum creatinine (recipient) at discharge was 1.14 mg% (range, 0.9-1.4). Conclusions : Transumbilical LESS-DN can be cost-effectively performed using conventional laparoscopy instruments and without the need for a single port access device. Warm ischemia times with this technique are comparable with that during conventional multiport laparoscopic donor nephrectomy.


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