More than 500 consecutive laparoscopic donor nephrectomies without conversion or repeated surgery

Marc L. Melcher, Jonathan T. Carter, Andrew Posselt, Quan Yang Duh, Marshall Stoller, Chris E. Freise, Sang Mo Kang, Susan Orloff

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Hypothesis: Concern exists as to the safety of laparoscopic donor nephrectomy (LDN) compared with open donor nephrectomy. Reported complications of LDN include emergent conversion to an open procedure, repeated surgery for postoperative bleeding, and even death. We hypothesize that LDNs can be performed safely, with a complication rate comparable with that of open donor nephrectomies. Design: Case series and review of the literature. Setting: Tertiary care university hospital. Patients: Five hundred thirty kidney donors. Intervention: An LDN performed without hand assistance, with the kidney extracted through a low transverse incision. Main Outcome Measures: Mean operative time, requirement for transfusion, intraoperative complications, and postoperative complications. Results: This series includes 84 right-sided donor nephrectomies, 86 donors with a body mass index greater than 30 (calculated as weight in kilograms divided by the square of height in meters), and 91 donors with complex vascular anatomy. Mean donor age was 40 years (range, 18-73 years), and mean±SD operative time was 196±43 minutes. The only conversion occurred early in the series, and there have been 525 subsequent cases without the need for conversion or repeated surgery. There were no donor deaths. Five donors (0.9%) required perioperative blood transfusions. Overall complication rate was 6.4%, including 14 minor wound infections, 2 bowel injuries, 1 case of prolonged ileus, 3 splenic injuries, 2 bladder infections, 1 bladder injury, 1 case of rhabdomyolysis, 1 case of pneumonia, and 2 thromboembolic events. Conclusion: This series demonstrates that LDN can be performed at least as safely as open donor nephrectomy, with minimal bleeding and few postoperative complications.

Original languageEnglish (US)
Pages (from-to)835-840
Number of pages6
JournalArchives of Surgery
Volume140
Issue number9
DOIs
StatePublished - Sep 2005
Externally publishedYes

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Nephrectomy
Tissue Donors
Operative Time
Wounds and Injuries
Urinary Bladder
Hemorrhage
Conversion to Open Surgery
Kidney
Rhabdomyolysis
Ileus
Intraoperative Complications
Wound Infection
Tertiary Healthcare
Blood Transfusion
Blood Vessels
Anatomy
Pneumonia
Body Mass Index
Hand
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

More than 500 consecutive laparoscopic donor nephrectomies without conversion or repeated surgery. / Melcher, Marc L.; Carter, Jonathan T.; Posselt, Andrew; Duh, Quan Yang; Stoller, Marshall; Freise, Chris E.; Kang, Sang Mo; Orloff, Susan.

In: Archives of Surgery, Vol. 140, No. 9, 09.2005, p. 835-840.

Research output: Contribution to journalArticle

Melcher, ML, Carter, JT, Posselt, A, Duh, QY, Stoller, M, Freise, CE, Kang, SM & Orloff, S 2005, 'More than 500 consecutive laparoscopic donor nephrectomies without conversion or repeated surgery', Archives of Surgery, vol. 140, no. 9, pp. 835-840. https://doi.org/10.1001/archsurg.140.9.835
Melcher, Marc L. ; Carter, Jonathan T. ; Posselt, Andrew ; Duh, Quan Yang ; Stoller, Marshall ; Freise, Chris E. ; Kang, Sang Mo ; Orloff, Susan. / More than 500 consecutive laparoscopic donor nephrectomies without conversion or repeated surgery. In: Archives of Surgery. 2005 ; Vol. 140, No. 9. pp. 835-840.
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