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TN03
RIGHT KIDNEYS ARE ALRIGHT!
Author(s) -
Robertson A. J.,
Millar R. J.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04933_3.x
Subject(s) - medicine , nephrectomy , surgery , kidney , kidney transplantation , transplantation , renal vein , renal artery
Purpose: Most Renal Transplant Units now perform living laparoscopic donor nephrectomy for transplantation, however, not all units are willing to take the right kidney. Many units prefer to take the left kidney with multiple vessels or perform an open right nephrectomy because of perceived technical difficulties. Methodology: A prospective review was performed of our first 120 laparoscopic hand‐assisted donor nephrectomies performed between September 2005 and December 2008. Either the right or left kidney was taken depending on the anatomy which was assessed pre‐operatively with CT angiogram. No patients were planned for open donor nephrectomy in this time. The laparoscopic technique is similar for each side with the addition of a 5 mm port on the right side to retract the liver. We use a hand port in all cases to maximise safety for the donor. The renal artery and vein are secured with vascular staplers. Results: We have performed 120 laparoscopic hand assisted donor nephrectomies in that time and including 23 (19%) right nephrectomies. We prefer to take the left kidney or the kidney with single vessels. The surgical time was usually under 120 minutes. There were 2 cases of staple misfires. One right nephrectomy was converted to open because of bleeding from a renal vein tributary. Another right kidney thrombosed day 2 post transplant because of size issues in the recipient. All other kidneys were successfully retrieved and transplanted. Conclusion: In our unit we prefer to transplant kidneys with single vessels. Both the right or left kidney can be retrieved using the laparoscopic hand assisted technique and we do not believe the length of the right renal vein is a problem for transplantation.