Gasless laparoscopy-assisted live donor nephrectomy: The initial 5 cases

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Abstract
Summary Since March 1993, we have performed gasless laparoscopy-assisted nephrectomy (GLAN) for patients with renal tumours and have found that it is a useful minimally invasive procedure. We have recently also performed GLAN for living kidney donors. The objectives of the present study were to evaluate the efficacy of GLAN for living kidney transplantation and to compare the results of GLAN and open donor nephrectomy. Since March 1995, we have performed GLAN for five living kidney donors. The surgical outcome and the post-operative graft function were compared with the results for donors operated on by open nephrectomy. The mean operating time and mean blood loss were 292.8 min and 185.2 ml in the five GLAN procedures. There were no operative or post-operative complications apart from blood loss of 500 ml in one obese donor whose right kidney was removed. Although the operating time was longer, the post-operative recovery of the donors was significantly more rapid than with open donor nephrectomy. GLAN could be advantageous for living kidney donors since it is minimally invasive. However, we feel that right-sided GLAN cannot currently be recommended in individuals with abundant perinephric fat.