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

Sun, Sep 23
10:00 AM - 12:00 PM

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

Niraj Kumar

Assistant Professor
Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi
Delhi, Delhi, India

Pawan Vasudeva

Professor
Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi
Delhi, Delhi, India

Siddharth Yadav

Assistant Professor
Department of Urology and Renal transplant , VMMC and Safdarjang Hospital ,New Delhi
Delhi, Delhi, India

Sandeep Kumar

Assistant Professor
Department of Urology and Renal Transplant ,VMMC and Safdarjang Hospital,New Delhi,India
Delhi, Delhi, India

Pankaj Gupta

Senior resident
Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India
Delhi, Delhi, India

Saurav Kumar

Senior Resident
Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India
Delhi, Delhi, India

Vishnu Prasad

Senior Resident
Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India
Delhi, Delhi, India

Y m Prashant

Senior Resident
Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India
Delhi, Delhi, India

Vijay Tyagi

senior Resident
Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, New Delhi, India
Delhi, Delhi, India