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LESS living donor nephrectomy: Surgical technique and results.

Alessimi A, Adam E, Haber GP, Badet L, Codas R, Fehri HF, Martin X, Crouzet S - Urol Ann (2015 Jul-Sep)

Bottom Line: LESS LDN was successful in all patients.Although challenging, trans-umbilical LESS LDN seems to be feasible and safe.Hence, LESS has the potential to improve cosmetic results and decrease morbidity.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Transplantation Edouard Herriot Hospital, Lyon, France.

ABSTRACT

Purpose: We present the findings of 50 patients undergoing pure trans-umbilical laparo-endoscopic single-site surgery (LESS) living donor nephrectomy (LDN), between February 2010 and May 2014.

Materials and methods: Laparo-endoscopic single-site surgery LDN was performed through an umbilical incision. Different trocars were used, namely Gelpoint (Applied Mιdical, Rancho Santa Margarita, CA) SILS port (Covidien, Hamilton, Bermuda), R-port (Olympus Surgical, Orangeburg, NY) and standard trocars, inserted through the same skin incision but using separate fascial punctures. The standard laparoscopic technique was employed. The kidney was pre-entrapped in a retrieval bag and extracted trans-umbilically. Data were collected prospectively including questionnaires containing patient reported oral pain medication duration and time to recovery.

Results: LESS LDN was successful in all patients. Mean warm ischemia time was 6.2 min (3-15), mean procedure time was 233.2 min (172-300), and hospitalization stay was 3.94 days (3-7) with a visual analogue pain score at discharge of 1.32 (0-3). No intraoperative complications occurred. The mean time of oral pain medication was 8.72 days (1-20) and final scar length was 4.06 cm (3-5). Each allograft was functional.

Conclusion: Although challenging, trans-umbilical LESS LDN seems to be feasible and safe. Hence, LESS has the potential to improve cosmetic results and decrease morbidity.

No MeSH data available.


Related in: MedlinePlus

Warm ischemia time according to body mass index
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Figure 1: Warm ischemia time according to body mass index

Mentions: The operating data are shown in Table 2. The average operating time was 233.2 min, and average duration of warm ischemia was 6.2 min with an average blood loss of 71 ml (20–150). The trends of warm ischemia and body mass index are presented in Figures 1 and 2. Average hospitalization was 3.94 days. From the point of view of postoperative pain, average EVA on the 1st day was 3.26 (1.5–5) and 1.32 (0–3) on the day of discharge with an average duration of oral analgesia of 8.72 days (1–20). Complete recovery after intervention occurred after 40.32 days (17–90).


LESS living donor nephrectomy: Surgical technique and results.

Alessimi A, Adam E, Haber GP, Badet L, Codas R, Fehri HF, Martin X, Crouzet S - Urol Ann (2015 Jul-Sep)

Warm ischemia time according to body mass index
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4518375&req=5

Figure 1: Warm ischemia time according to body mass index
Mentions: The operating data are shown in Table 2. The average operating time was 233.2 min, and average duration of warm ischemia was 6.2 min with an average blood loss of 71 ml (20–150). The trends of warm ischemia and body mass index are presented in Figures 1 and 2. Average hospitalization was 3.94 days. From the point of view of postoperative pain, average EVA on the 1st day was 3.26 (1.5–5) and 1.32 (0–3) on the day of discharge with an average duration of oral analgesia of 8.72 days (1–20). Complete recovery after intervention occurred after 40.32 days (17–90).

Bottom Line: LESS LDN was successful in all patients.Although challenging, trans-umbilical LESS LDN seems to be feasible and safe.Hence, LESS has the potential to improve cosmetic results and decrease morbidity.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Transplantation Edouard Herriot Hospital, Lyon, France.

ABSTRACT

Purpose: We present the findings of 50 patients undergoing pure trans-umbilical laparo-endoscopic single-site surgery (LESS) living donor nephrectomy (LDN), between February 2010 and May 2014.

Materials and methods: Laparo-endoscopic single-site surgery LDN was performed through an umbilical incision. Different trocars were used, namely Gelpoint (Applied Mιdical, Rancho Santa Margarita, CA) SILS port (Covidien, Hamilton, Bermuda), R-port (Olympus Surgical, Orangeburg, NY) and standard trocars, inserted through the same skin incision but using separate fascial punctures. The standard laparoscopic technique was employed. The kidney was pre-entrapped in a retrieval bag and extracted trans-umbilically. Data were collected prospectively including questionnaires containing patient reported oral pain medication duration and time to recovery.

Results: LESS LDN was successful in all patients. Mean warm ischemia time was 6.2 min (3-15), mean procedure time was 233.2 min (172-300), and hospitalization stay was 3.94 days (3-7) with a visual analogue pain score at discharge of 1.32 (0-3). No intraoperative complications occurred. The mean time of oral pain medication was 8.72 days (1-20) and final scar length was 4.06 cm (3-5). Each allograft was functional.

Conclusion: Although challenging, trans-umbilical LESS LDN seems to be feasible and safe. Hence, LESS has the potential to improve cosmetic results and decrease morbidity.

No MeSH data available.


Related in: MedlinePlus