Comparison of Techniques of Vascular Control in Laparoscopic Donor Nephrectomy: The Leicester Experience

• Published in: Transplantation proceedings Vol. 38; no. 10; pp. 3406 - 3408
• Main Authors: Kaushik, M., Bagul, A., Yates, P.J., Elwell, R., Nicholson, M.L.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2006; Elsevier Science
• Subjects: Biological and medical sciences; Digestive system. Abdomen; Endoscopy; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Intraoperative Complications - prevention & control; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy - methods; Living Donors; Medical sciences; Nephrectomy - methods; Renal Artery - anatomy & histology; Renal Circulation; Renal Veins - anatomy & histology; Safety; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue and Organ Harvesting - methods; Tissue and Organ Harvesting - standards; Tissue, organ and graft immunology; Endoscopic surgery; Living donor; Check; Laparoscopy; Transplantation; Kidney; Medicine; Experience; Treatment; Urinary system; Nephrectomy; Surveillance; Blood vessel; Graft; Circulatory system; Endoscopy; Organ harvesting; Technique; Comparative study
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2006.10.142

The objective of this study was to compare the safety and efficacy of three different methods to secure the renal vessels during laparoscopic donor nephrectomy (LDN). Vessel lengths and intraoperative vascular complications were compared in a prospective series of 106 LDNs in which the vessels had been secured using a stapling device, metal clips, or polymer clips. One hundred six patients underwent LDN (right = 25, left = 81). Renal vein lengths were not significantly different after stapling or using polymer clips (36 ± 10 vs 37 ± 9 mm; P = .463). Renal arterial length was shorter after stapling (30 ± 7 mm) compared with both endoclips (34 ± 10 mm; P = .030) and polymer clips (34 ± 8 mm; P = .030). There was one major arterial bleed in the endoclip group, one episode of stapler malfunction, but no adverse events with polymer clips. Polymer clips are safe and yield greater vessel lengths during LDN.