Laparo-endoscopic single-site （LESS）donor nephrectomy using straight instruments

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  • Inoue Takamitsu
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Narita Shintaro
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Saito Mitsuru
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Numakura Kazuyuki
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Akihama Susumu
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Tsuchiya Norihiko
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Satoh Shigeru
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine
  • Habuchi Tomonori
    Department of Urology and Division of Renal Replacement Therapeutic Science, Akita University Graduate School of Medicine

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Other Title
  • ストレート鉗子のみで行う単孔式腹腔鏡下ドナー
  • ストレート鉗子のみで行う単孔式腹腔鏡下ドナー腎採取術
  • ストレート カンシ ノミ デ オコナウ タンコウシキ フククウキョウ カ ドナージンサイシュジュツ

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Abstract

  Laparoendoscopic single site surgery （LESS） donor nephrectomy （LESSDN） has provided favorable results regarding invasiveness and cosmesis. Although it is demanding to perform LESS surgeries via a 2 cm single incision without employing articulating instruments, LESSDN might be well performed by straight instruments alone via a 5 cm single incision using a GelPOINTⓇ. We present our experience of LESSDN using a GelPOINTⓇ without using articulating instruments. Perioperative results of a total of 20 living donors who underwent LESSDN were compared with those of 27 donors who underwent standard 4-trocar-laparoscopic donor nephrectomy （Std-LDN）. The mean operative time, warm ischemic time and postoperative hospital stay of the LESSDN group were significantly shorter than that in the Std-LDN group （p < 0.001, p = 0.015, and p < 0.001）. There were no complications or delayed graft function in both groups. No significant difference in 7-days posttransplant serum creatinine level was observed. The LESSDN using a GelPOINTⓇ was safely and efficiently performed using straight instruments alone with better cosmetic outcome and less invasiveness.

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