Category: Laparoscopy: Upper Tract - Benign
VS13-3 - A prospective evaluation of donor and graft outcomes of 3-D laparoscopic donor nephrectomy :A single centre experience
Introduction & Objective :
Laparoscopic donor nephrectomy(LDN) is the standard of care for kidney retrieval from living donors .LDN has shown shorter convalescence and hospital stay .However,there are concerns about donor safety as well as graft function for LDN.The use of 3-D laparoscopy results in improved magnification ,better perception of depth and precise dissection .We prospectively evaluated the donor and graft outcomes of 3-D laparoscopic donor nephrectomy with long term follow up.This is the first series reported of 3-D LDN from India.
Methods : All consecutive patients undergoing 3-D lap donor nephrectomy by a single surgeon ,between March 2014 and January 2018 , at our institution were included in the study .The various data including demographic ,peri-operative ,postoperative complications and follow up of the donors and recipients were collected and analyzed .We are presenting video of one such case.
Results :
A total of 110 patients were included in the study. The mean age was 33.7 years with mean preoperative serum creatinine and mean glomerular filtration rate ( GFR) were 1.09 mg/dl and 90.5 ml/min/1.73 m 2 respectively.The male to female distribution and right to left distribution were 45(40.9%)/65 and 25(22.7%)/85 respectively .The multiple arteries were present in 29(26.3%) – 2 arteries and 19(17.3%) – 3 arteries . The mean operating time and estimated blood loss were 153.5 min and 101.7 ml respectively .The mean warm ischemia time was 1.9 min.There was no conversion to open. There were no intraoperative complications.The mean hospital stay and mean catheter removal time were 1.9 and 0.9 days respectively .The mean convalescence was 1.7 weeks.The postoperative complications were mainly Clavien 1 and 2 in total 15(13.6%) donor patients .In recipents ,ureter leak and lymphocele were observed in 4.5% and 6.3% patients respectively .At mean follow up of 37.3 months ,mean recipient’s serum creatinine was 0.8,0.9 and 0.9 mg/dl respectively at 1 ,2 and 3 years .The mean donor’s serum creatinine was preserved at 1.10,1.15 and 1.14 mg/dl at 1,2 and 3 years respectively .
Conclusions :
3-D Laparoscopic donor nephrectomy is feasible ,safe with excellent 3 years donor and graft function outcomes.
Anup Kumar
– Professor and Head, Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi, Delhi, Delhi, India- NK
Niraj Kumar
– Assistant Professor, Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi, Delhi, Delhi, India - PV
Pawan Vasudeva
– Professor, Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi, Delhi, Delhi, India - SY
Siddharth Yadav
– Assistant Professor, Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi, Delhi, Delhi, India - SK
Sandeep Kumar
– Assistant Professor, Department of Urology and Renal Transplant ,VMMC and Safdarjang Hospital,New Delhi,India, Delhi, Delhi, India - PG
Pankaj Gupta
– Senior resident, Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India, Delhi, Delhi, India - SK
Saurav Kumar
– Senior Resident, Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India, Delhi, Delhi, India - VP
Vishnu Prasad
– Senior Resident, Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India, Delhi, Delhi, India - YP
Y m Prashant
– Senior Resident, Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India, Delhi, Delhi, India - VT
Vijay Tyagi
– senior Resident, Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India, Delhi, Delhi, India