Surgery Illustrated - Surgical Atlas Laparoscopic right donor nephrectomy

摘要

Since the first description of laparoscopic donor nephrectomy (LDN) in 1995 by Ratner eta/. LDN has become the preferred, method of kidney donation at most kidney transplantation centres. The technique for LDN continues to be refined, with advances in laparoscopic instruments, surgical techniques and experience.Traditionally surgeons have preferred left LDN as the vein on the left side is longer. However, certain instances can preclude the harvesting of the left kidney, like multiple renal arteries or veins, a cystic mass in the right kidney, smaller right kidney or a 10% difference in renal function compared with the left kidney . In many centres the procurement of a right kidney laparoscopically is viewed with reluctance, due to concerns of inadequate renal vein length, and a possible higher incidence of venous thrombosis . Thus the percentage of right DNs done laparoscopically is 0-4%, vs 26-37% in open DN ,