IS LAPAROSCOPY REALLY USEFUL IN LIVING DONOR NEPHRECTOMY ? A comparative study of mini open donor nephrectomy Vs laparoscopic donor nephrectomy.

Arun Sirandas; Subba Rao Chodisetti; Mohan Rao AV; Manohar Guda

Volume : IX, Issue : III, March - 2019

IS LAPAROSCOPY REALLY USEFUL IN LIVING DONOR NEPHRECTOMY ? A comparative study of mini open donor nephrectomy Vs laparoscopic donor nephrectomy.

Arun Sirandas, Subba Rao Chodisetti, Mohan Rao Av, Manohar Guda

Abstract :

Introduction: Laparoscopic donor nephrectomy is the standard of care at many renal transplant centres, with benefits over the open approach well–documented in the literature. However attractive as it may seem, the procedure is associated with a definite learning curve and does compromise donor safety. The procedure is also expensive . The mini–donor nephrectomy is an excellent alternative, has no learning curve and is ideally suited for donors in India who have a low BMI. Here in, we present a retrospective analysis of our single–institution donor nephrectomy series compå the mini–open donor nephrectomy (mini–ODN) to the laparoscopic donor nephrectomy (LDN) with regards to operative, donor, and recipient outcomes. Methods: From January 2014‒January 2017, In total, 67 patients were reviewed, there were 35 cases of mini–ODN, 32 cases were LDN . Both the groups were reviewed in terms of operative time , warm ischemia time, vessel lengths, postoperative donor recovery, recipient graft outcomes for compå the surgical approaches. Results: There were significant differences in favour of mini–ODN regarding operative time, warm ischemia time, and vessel lengths, whereas the analgesic requirements and pain data were significantly in favour of the laparoscopic procedure. Conclusions: These results from our study suggests mini–ODN is a very secure procedure, superior to LDN regarding donor safety. The high costs and the training required for laparoscopy have been major deterrents to its widespread use in India.