Hand-assisted laparoscopic donor nephrectomy versus standard laparoscopic donor nephrectomy: A comparison study in the canine model

P. I. Ravizzini, D. Shulsinger, E. Guarnizo, Christian Pavlovich, D. Marion, E. R. Sosa

Research output: Contribution to journalArticle

Abstract

The aim of this study was to compare live donor nephrectomy by hand- assisted laparoscopy to standard laparoscopy in a canine model. Fourteen dogs underwent a left laparoscopic nephrectomy; a standard laparoscopic nephrectomy technique was utilized in seven dogs. In a second group of seven dogs, a hand-assisted laparoscopic technique was used with a Dexterity Pneumo Sleeve(TM) hand port. All nephrectomies were performed as 'donor' nephrectomies, dividing the vessels last. Total blood loss, operative warm ischemia, time and organ retrieval times were assessed for each group. The average operative time was significantly shorter for hand-assisted laparoscopic donor nephrectomy (32 ± 8 minutes vs. 61 ± 8 minutes; p = .02) than for the standard technique. The average warm ischemia (86 ± 24 seconds vs. 224 ± 52 seconds; p = .03) and average organ delivery times (4 ± 3 seconds vs. 45 ± 9 seconds; p <.01) also were shorter using the hand- assisted laparoscopic technique. No significant differences in average blood loss were found between the two groups (9 ± 2 cc vs. 6 ± 1 cc; p = 0.16, NS). Good parenchymal, ureteral, and vascular preservation was achieved by both techniques. Hand-assisted laparoscopy permits shorter operating times and warm ischemia times than standard laparoscopy in a canine model of donor nephrectomy. Hand assistance makes donor laparoscopic nephrectomy technically easier and significantly quicker to perform. If hand-assisted laparoscopy donor nephrectomy is confirmed to be a rapid and safe technique for removing an intact organ, laparoscopic nephrectomy will be a more widely accepted technique among urologists who participate in living related donor kidney transplantation.

Original languageEnglish (US)
Pages (from-to)174-178
Number of pages5
JournalTechniques in Urology
Volume5
Issue number3
Publication statusPublished - 1999
Externally publishedYes

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Keywords

  • Donor nephrectomy
  • Hand-assisted laparoscopy
  • Operative time
  • Organ delivery time
  • Warm ischemia time

ASJC Scopus subject areas

  • Urology

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