Laparoscopic Donor Nephrectomy Current Status

Michael W. Phelan and Stephen C. Jacobs

Division University of Maryland School of Medicine, Baltimore, Maryland, U.S.A.

INITIAL EXPERIENCE AND MOTIVATION

EXPANSION OF LIVE RENAL DONATION

EARLY CONTROVERSIES

Age

Pneumoperitoneum

Obesity

Warm Ischemia Time

Renal Stones

Ureteral Complications

Renal Cysts

Laterality of Nephrectomy

Malignancies

Extraction Sites

Other Measures

UNSOLVED CONTROVERSIES

CURRENT STATUS OF LAPAROSCOPIC

Vascular Control

APPROACH

Skill Levels Required for Teaching

Expansion of Laparoscopic Approach

SURGICAL TECHNICAL ISSUES

International Experience

Approach

SUMMARY

Robotics

REFERENCES

DONOR EVALUATION

COMMENTARY: John M. Barry

In many open donor series, the complication rates were as low as 1% to 8%, and early graft loss was extremely rare. To gain wide acceptance, laparoscopic donor nephrectomy appropriately had to meet the standards set by open donor nephrectomy.

Table 1 shows that, in current series, the total operating time required to perform laparoscopic donor nephrectomy is comparable to that required for open surgery. In our review of 59 series, comprising 3330 donors, operative time for laparoscopic donor nephrectomy averaged 3 hours 45 minutes.

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