+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Hand-assisted laparoscopic live donor nephrectomy in a patient with renal artery aneurysm

Hand-assisted laparoscopic live donor nephrectomy in a patient with renal artery aneurysm

Surgical Endoscopy 15(1): 101

Among the transplantation teams there is an increasing interest in laparoscopic live donor nephrectomy. For technical reasons, the use of the left kidney is recommended. However, considering the shortage of organ donors, it is likely that right-side laparoscopic live donor nephrectomy will need to be considered in selected donors, even those with vascular anomalies. Here we report the first case of right-side live donor laparoscopic nephrectomy in a patient with a renal artery aneurysm. Arteriography showed a 3-cm saccular aneurysm of the main right renal artery located at the bifurcation of the secondary branches and associated with an inferior polar artery coming directly from the aorta. The patient was placed in the lumbotomy position. An 8-cm midline incision was made above the umbilicus to insert the HandPort system (Smith & Nephew S.A., 72019 Le Mans Cedex2, France). Four additional trocars were introduced. Dissection of the renal artery was carried out beyond the level of relieving the aneurysm behind the vena cava. The main and polar arteries were clipped, and the renal vein was stapled. The kidney was removed through the HandPort and perfused cold ex vivo. The warm ischemia time for the kidney was 1 min, and the total operative time was 280 min. Vascular abnomalies were corrected ex vivo. The postoperative course of the donor was uneventful. At 6 months after transplantation, the graft function was normal. The hand-assisted approach is of particular value on the right side where the dissection must be carried out behind the vena cava. The HandPort may save few precious minutes over the sac extraction technique of the standard laparoscopic procedure.

(PDF emailed within 0-6 h: $19.90)

Accession: 046211043

Download citation: RISBibTeXText

PMID: 11285545

DOI: 10.1007/s004640040015

Related references

Renal artery aneurysm in hand-assisted laparoscopic donor nephrectomy: case report. Transplantation Proceedings 35(8): 2858-2859, 2003

Comparison of open live donor nephrectomy, laparoscopic live donor nephrectomy, and hand-assisted live donor nephrectomy: a cost-minimization analysis. Journal of Surgical Research 176(2): E89-E94, 2012

Hand-assisted laparoscopic surgery (HALS) for live donor nephrectomy is more time- and cost-effective than standard laparoscopic nephrectomy. Surgical Endoscopy 16(3): 422-425, 2002

Renal Function Recovery in Donors and Recipients after Live Donor Nephrectomy: Hand-Assisted Laparoscopic vs. Open Procedures. Korean Journal of Urology 51(4): 245-249, 2010

Renal artery clip dislodgement during hand-assisted laparoscopic living donor nephrectomy. Surgical Endoscopy 17(11): 1851, 2004

Comparison of recovery between open live donor nephrectomy and hand-assisted laparoscopic nephrectomy. Journal of Urology 159(5 SUPPL ): 116, 1998

Comparison of renal artery occlusion techniques in hand-assisted laparoscopic living donor nephrectomy. Journal of Endourology 23(6): 933-937, 2009

Complex renal artery aneurysm managed with hand-assisted laparoscopic nephrectomy, ex vivo repair, and autotransplantation. Annals of Vascular Surgery 28(4): 1036.E9-1036.E13, 2015

Control of the renal artery and vein with the nonabsorbable polymer ligating clip in hand-assisted laparoscopic donor nephrectomy. Transplantation 80(3): 310-313, 2005

Hand-assisted laparoscopic live-donor nephrectomy. Journal of the American College of Surgeons 192(1): 132-136, 2001

Hand-assisted right laparoscopic live donor nephrectomy. International Braz J Urol 31(5): 421-9; Discussion 429-30, 2005

Hand-assisted laparoscopic live donor nephrectomy. British Journal of Surgery 91(3): 344-348, 2004

Comparison of 100 consecutive hand-assisted laparoscopic donor nephrectomies to open live donor nephrectomy. Journal of Urology 167(4 Supplement): 370, April, 2002

How safe is hand-assisted laparoscopic donor nephrectomy?--results of 200 live donor nephrectomies by two different techniques. Nephrology, Dialysis, Transplantation 24(1): 293-297, 2008

Laparoscopic and hand-assisted laparoscopic live donor nephrectomy. Seminars in Laparoscopic Surgery 8(2): 161-167, 2001