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Hand-Assisted Technique Facilitates Preserving Graft Viability in Laparoscopic Donor Nephrectomy
Abstract Background To achieve Patient Safety and minimal operative invasion in living kidney donor nephrectomy, we have performed hand-assisted laparoscopic donor nephrectomy (HALDoN) since 2006. Aim The aim of this study was to evaluate the utility and the technique of HALDoN. Method We analyzed 7...
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| Published in: | Transplantation proceedings 2012, Vol.44 (1), p.26-29 |
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| creator | Marui, Y Nakamura, M Tanaka, K Tomikawa, S |
| description | Abstract Background To achieve Patient Safety and minimal operative invasion in living kidney donor nephrectomy, we have performed hand-assisted laparoscopic donor nephrectomy (HALDoN) since 2006. Aim The aim of this study was to evaluate the utility and the technique of HALDoN. Method We analyzed 72 donors who underwent HALDoN from February 2008–August 2011. Results Including 8/72 donors who underwent right nephrectomy, all subjects completed HALDoN without conversion to an open procedure. None of the recipients suffered delayed graft function or an ureteric problem. Knife-to-removal time (KRT) was longer among cases with graft weight (GW) >200 g than GW ≤200 g: 176.5 ± 35.1 minutes vs 142 ± 18.7 minutes ( P < .001). Longer KRT (>180 minutes) and right nephrectomy produced longer reperfusion-to-urine secretion time (RUT; P = .002 and P = .027, respectively). Grafts with double renal arteries (N = 10) also tended to show longer RUT ( P = .058). In a case with an early renal arterial branch |
| doi_str_mv | 10.1016/j.transproceed.2011.12.012 |
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Aim The aim of this study was to evaluate the utility and the technique of HALDoN. Method We analyzed 72 donors who underwent HALDoN from February 2008–August 2011. Results Including 8/72 donors who underwent right nephrectomy, all subjects completed HALDoN without conversion to an open procedure. None of the recipients suffered delayed graft function or an ureteric problem. Knife-to-removal time (KRT) was longer among cases with graft weight (GW) >200 g than GW ≤200 g: 176.5 ± 35.1 minutes vs 142 ± 18.7 minutes ( P < .001). Longer KRT (>180 minutes) and right nephrectomy produced longer reperfusion-to-urine secretion time (RUT; P = .002 and P = .027, respectively). Grafts with double renal arteries (N = 10) also tended to show longer RUT ( P = .058). In a case with an early renal arterial branch <1 cm from the aorta, we transected the vessel to achieve a single orifice of the artery using a stapling device. At 6 months the average value of decreased renal function of donors had recovered to about 70%. The incidence of complication was 8.3% but there was no life-threatening morbidity. Conclusion The hand-assisted method could make the operating surgeon more confident to perform laparoscopic donor nephrectomy safely. HALDoN offers particular advantages for precise dissection using finger retraction and control of potential bleeding in the stages of vascular stapling and graft removal, preserving graft viability.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2011.12.012</identifier><identifier>PMID: 22310569</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>Amsterdam: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Digestive system. Abdomen ; Endoscopy ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Survival ; Hand-Assisted Laparoscopy - adverse effects ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Japan ; Kidney Transplantation - adverse effects ; Laparoscopy - adverse effects ; Living Donors ; Male ; Medical sciences ; Middle Aged ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Postoperative Complications - etiology ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Time Factors ; Tissue and Organ Harvesting - adverse effects ; Tissue and Organ Harvesting - methods ; Tissue Survival ; Tissue, organ and graft immunology ; Treatment Outcome</subject><ispartof>Transplantation proceedings, 2012, Vol.44 (1), p.26-29</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-d055d22a867867e651cbb207f24b1cf5fe155e13eb36891807046e1c1045b2553</citedby><cites>FETCH-LOGICAL-c464t-d055d22a867867e651cbb207f24b1cf5fe155e13eb36891807046e1c1045b2553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>310,311,315,786,790,795,796,4043,4069,4070,23958,23959,25170,27956,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25919855$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22310569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marui, Y</creatorcontrib><creatorcontrib>Nakamura, M</creatorcontrib><creatorcontrib>Tanaka, K</creatorcontrib><creatorcontrib>Tomikawa, S</creatorcontrib><title>Hand-Assisted Technique Facilitates Preserving Graft Viability in Laparoscopic Donor Nephrectomy</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>Abstract Background To achieve Patient Safety and minimal operative invasion in living kidney donor nephrectomy, we have performed hand-assisted laparoscopic donor nephrectomy (HALDoN) since 2006. Aim The aim of this study was to evaluate the utility and the technique of HALDoN. Method We analyzed 72 donors who underwent HALDoN from February 2008–August 2011. Results Including 8/72 donors who underwent right nephrectomy, all subjects completed HALDoN without conversion to an open procedure. None of the recipients suffered delayed graft function or an ureteric problem. Knife-to-removal time (KRT) was longer among cases with graft weight (GW) >200 g than GW ≤200 g: 176.5 ± 35.1 minutes vs 142 ± 18.7 minutes ( P < .001). Longer KRT (>180 minutes) and right nephrectomy produced longer reperfusion-to-urine secretion time (RUT; P = .002 and P = .027, respectively). Grafts with double renal arteries (N = 10) also tended to show longer RUT ( P = .058). In a case with an early renal arterial branch <1 cm from the aorta, we transected the vessel to achieve a single orifice of the artery using a stapling device. At 6 months the average value of decreased renal function of donors had recovered to about 70%. The incidence of complication was 8.3% but there was no life-threatening morbidity. Conclusion The hand-assisted method could make the operating surgeon more confident to perform laparoscopic donor nephrectomy safely. HALDoN offers particular advantages for precise dissection using finger retraction and control of potential bleeding in the stages of vascular stapling and graft removal, preserving graft viability.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Survival</subject><subject>Hand-Assisted Laparoscopy - adverse effects</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Japan</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Laparoscopy - adverse effects</subject><subject>Living Donors</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Postoperative Complications - etiology</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Time Factors</subject><subject>Tissue and Organ Harvesting - adverse effects</subject><subject>Tissue and Organ Harvesting - methods</subject><subject>Tissue Survival</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNktGL1DAQxoMo3nr6L0gRxKfWTNKkrQ_CcefdCYsKnr7GNJ16WbtpzXQP9r83dfdQfBICQ5hvvvn4MYy9AF4AB_16U8zRBpri6BC7QnCAAkTBQTxgK6grmQst5EO24ryEHGSpTtgTog1Pf1HKx-xECAlc6WbFvl3b0OVnRJ5m7LIbdLfB_9xhdmmdH_xsZ6TsU0TCeOfD9-wq2n7OvnrbLt195kO2tpONI7lx8i67GMMYsw843UZ087jdP2WPejsQPjvWU_bl8t3N-XW-_nj1_vxsnbtSl3PecaU6IWytq_RQK3BtK3jVi7IF16seQSkEia3UdQM1r3ipERzwUrVCKXnKXh18E5aUn2az9eRwGGzAcUemEVzqpq51Ur45KF1KTRF7M0W_tXFvgJsFsNmYvwGbBbABYRLgNPz8uGbXblPvfvSeaBK8PAosOTv0ych5-qNTDTT177wXBx0mKHceoyHnMTjs_ELOdKP_vzxv_7Fxgw8-bf6Be6TNuIshYTdgKA2Yz8tJLBcBi3FVKvkLgyy1JA</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Marui, Y</creator><creator>Nakamura, M</creator><creator>Tanaka, K</creator><creator>Tomikawa, S</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Hand-Assisted Technique Facilitates Preserving Graft Viability in Laparoscopic Donor Nephrectomy</title><author>Marui, Y ; Nakamura, M ; Tanaka, K ; Tomikawa, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-d055d22a867867e651cbb207f24b1cf5fe155e13eb36891807046e1c1045b2553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Survival</topic><topic>Hand-Assisted Laparoscopy - adverse effects</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Japan</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Laparoscopy - adverse effects</topic><topic>Living Donors</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrectomy - methods</topic><topic>Postoperative Complications - etiology</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Time Factors</topic><topic>Tissue and Organ Harvesting - adverse effects</topic><topic>Tissue and Organ Harvesting - methods</topic><topic>Tissue Survival</topic><topic>Tissue, organ and graft immunology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marui, Y</creatorcontrib><creatorcontrib>Nakamura, M</creatorcontrib><creatorcontrib>Tanaka, K</creatorcontrib><creatorcontrib>Tomikawa, S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marui, Y</au><au>Nakamura, M</au><au>Tanaka, K</au><au>Tomikawa, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hand-Assisted Technique Facilitates Preserving Graft Viability in Laparoscopic Donor Nephrectomy</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2012</date><risdate>2012</risdate><volume>44</volume><issue>1</issue><spage>26</spage><epage>29</epage><pages>26-29</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Abstract Background To achieve Patient Safety and minimal operative invasion in living kidney donor nephrectomy, we have performed hand-assisted laparoscopic donor nephrectomy (HALDoN) since 2006. Aim The aim of this study was to evaluate the utility and the technique of HALDoN. Method We analyzed 72 donors who underwent HALDoN from February 2008–August 2011. Results Including 8/72 donors who underwent right nephrectomy, all subjects completed HALDoN without conversion to an open procedure. None of the recipients suffered delayed graft function or an ureteric problem. Knife-to-removal time (KRT) was longer among cases with graft weight (GW) >200 g than GW ≤200 g: 176.5 ± 35.1 minutes vs 142 ± 18.7 minutes ( P < .001). Longer KRT (>180 minutes) and right nephrectomy produced longer reperfusion-to-urine secretion time (RUT; P = .002 and P = .027, respectively). Grafts with double renal arteries (N = 10) also tended to show longer RUT ( P = .058). In a case with an early renal arterial branch <1 cm from the aorta, we transected the vessel to achieve a single orifice of the artery using a stapling device. At 6 months the average value of decreased renal function of donors had recovered to about 70%. The incidence of complication was 8.3% but there was no life-threatening morbidity. Conclusion The hand-assisted method could make the operating surgeon more confident to perform laparoscopic donor nephrectomy safely. HALDoN offers particular advantages for precise dissection using finger retraction and control of potential bleeding in the stages of vascular stapling and graft removal, preserving graft viability.</abstract><cop>Amsterdam</cop><pub>Elsevier Inc</pub><pmid>22310569</pmid><doi>10.1016/j.transproceed.2011.12.012</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Digestive system. Abdomen Endoscopy Female Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Survival Hand-Assisted Laparoscopy - adverse effects Humans Investigative techniques, diagnostic techniques (general aspects) Japan Kidney Transplantation - adverse effects Laparoscopy - adverse effects Living Donors Male Medical sciences Middle Aged Nephrectomy - adverse effects Nephrectomy - methods Postoperative Complications - etiology Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Time Factors Tissue and Organ Harvesting - adverse effects Tissue and Organ Harvesting - methods Tissue Survival Tissue, organ and graft immunology Treatment Outcome |
| title | Hand-Assisted Technique Facilitates Preserving Graft Viability in Laparoscopic Donor Nephrectomy |
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