Donor Nephrectomy

Standard transperitoneal laparoscopic and hand-assisted laparoscopy donor nephrectomy have been compared in six nonrandomized, retrospective series (Table 7) (44-47,50,67). The comparison of standard laparoscopy and hand-assisted laparoscopy is cleanest for this procedure, because candidates for donor nephrectomy are fairly a homogenous group. The results of all six studies have been remarkably similar.

Although recovery parameters were not assessed in a similar fashion, in three of the studies (44,47,67) there tended to be more postoperative narcotic use and/or slightly longer duration of convalescence in the hand-assisted laparoscopy group.

Hand-assisted laparoscopy tends to be faster and associated with shorter warm ischemia time. While there is also a small trend to fewer complications, less frequent conversion to open surgery, and shorter hospital stay, the differences are not clinically significant.

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