Surgical Techniques in UrologyHybrid Technique Using a Satinsky Clamp for Right-sided Transperitoneal Hand-assisted Laparoscopic Donor Nephrectomy: Comparison With Left-sided Standard Hand-assisted Laparoscopic Technique
Section snippets
Methods
This study was approved by the Institutional Review Board of Kyungpook National University Hospital. From January 2003 to December 2012, single surgeon performed 253 HALDNs including 51 (20.2%) cases of right hybrid HALDN (rhHALDN). Each volunteer for kidney donation underwent a standard preoperative immunologic and medical examination to confirm his or her suitability. Conventional renal angiography with magnetic resonance angiography or 3-dimensional spiral computerized tomography was used to
Results
The operation was performed successfully in all 253 patients. The reasons for right-sided donor nephrectomy were multiple left renal vessels (n = 21), a difference in split renal function of >10% as determined by radionuclide renal scan (n = 16), and early left renal artery bifurcation (n = 14). Forty-five patients had single right renal arteries (88.2%), and 6 patients had double right renal arteries (11.8%). Fifty patients had single right renal veins (98.0%), and 1 patient had a double right
Comment
Compared with open donor nephrectomy, laparoscopic donor nephrectomy is associated with less blood loss, decreased analgesic requirement, shorter hospital stay, improved cosmetic results, and earlier return to normal activity.20 Despite the development of surgical technique of laparoscopic donor nephrectomy, most of the donor nephrectomies are performed on the left side, which is preferred owing to longer renal vein and the easier procedure of transplantation.
Mandal et al9 reported a
Conclusion
With respect to donor safety, organ quality, and operative time, the perioperative outcomes of rhHALDN using a Satinsky clamp was comparable with those of 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.
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Cited by (8)
Endo-Satinsky Clamp Hybrid In Situ Perfusion in Retroperitoneoscopic Donor Nephrectomy For Right-sided Kidney
2019, UrologyCitation Excerpt :Although most of the recipients showed promising surgical outcomes, it was necessary to monitor the postoperative stricture or thrombosis of the renal vein by doppler ultrasound over a long duration after surgery, and as a result, caused cost increases and prolonged hospital stays. Since 2016, we have worked to establish a modified RDN technique for kidney procurement based on the findings of previous work.10,14 This study provides a feasible alternative of LDN, which better assures the length of renal vein procurement, overall cost reduction, and most importantly, decrease in the risks of postoperative stricture or thrombosis of the renal vein.
Open Management of the Renal Vein Is a Safe Modification in Right-Sided Laparoscopic Living Donor Nephrectomy to Maximize Graft Vein Length
2018, Transplantation ProceedingsCitation Excerpt :To save this length, we have adopted and further modified a technique first described by Ratner et al [16] and later by a Chinese group [17] in 2011 as semi-open retroperitoneal nephrectomy. With this approach, the kidney is dissected laparoscopically, and the vein is managed via an open approach [17]. A Brazilian group described a hand-assisted living donor nephrectomy in which a Satinsky clamp is introduced into the abdominal cavity through the hand port and the inferior vena cava is oversewn laparoscopically [18].
Massive Chylous Ascites After Living Donor Nephrectomy Successfully Treated With Lymphatic Embolization
2022, Journal of Investigative Medicine High Impact Case ReportsMidline rotation of the right renal hilum during hand-assisted laparoscopic living donor nephrectomy
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Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: This research was supported by Kyungpook National University Research Fund, 2012.