Laparoscopic Donor Nephrectomy Home



Recently, donor nephrectomy has been performed using minimally invasive surgery. The first laparoscopic living donor nephrectomy was carried out in 1995 at the Johns Hopkins Medical Centre and since then many centres in the USA and elsewhere, including at least two in the UK, have undertaken laparoscopic living donor nephrectomy.3 Advocates of laparoscopic nephrectomy (or laparoscopic assisted nephrectomy) argue that it substantially reduces the wound-related problems associated with open nephrectomy.4,5,6,7 There have not been any controlled clinical trials of laparoscopic versus open living donor nephrectomy. However, blood loss, requirement for post-operative analgesia, length of hospital stay and time until return to normal activity are all lower in patients undergoing laparoscopic nephrectomy than in historical controls undergoing open nephrectomy.4,5,6,7 During laparoscopic nephrectomy, warm ischaemia times of 3-5 minutes are reported, raising concern that ischaemic injury may result. Although data following laparoscopic living donor nephrectomy is still limited, immediate function rate and graft survival appear broadly comparable to that reported for open nephrectomy. Laparoscopic living donor nephrectomy requires expertise in advanced laparoscopic techniques and should only be undertaken by surgeons with appropriate training in the technique. This requirement may limit the availability of laparoscopic living donor nephrectomy in the UK, at least for the time being.