Wang David S, Bird Vincent G, Winfield Howard N, Rayhill Stephen
Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
J Endourol. 2004 Apr;18(3):205-09; discussion 209-10. doi: 10.1089/089277904773582769.
Many centers have adopted laparoscopic and hand-assisted laparoscopic (HAL) techniques for live donor nephrectomy. Currently, the majority of laparoscopic living donor kidneys are procured from the left side because of the longer renal vein and improved transplantation. However, indications exist for right donor nephrectomy. We present our technique of HAL right-sided donor nephrectomy. A key feature of our dissection is wide mobilization of adjacent structures to achieve good exposure of the right kidney and inferior vena cava. In addition, the use of the hand permits optimal positioning of the kidney for division of the renal vessels with the vascular stapler. At the time of division of the renal vein, the stapler is placed on the wall of the inferior vena cava in order to gain maximal length. This technique has allowed HAL right-sided donor nephrectomy to be performed safely when indicated.
许多中心已采用腹腔镜和手辅助腹腔镜（HAL）技术进行活体供肾肾切除术。目前，由于肾静脉较长且有利于移植，大多数腹腔镜活体供肾是从左侧获取的。然而，右侧供肾肾切除术也有适应证。我们介绍我们的HAL右侧供肾肾切除术技术。我们解剖的一个关键特征是广泛游离相邻结构，以充分暴露右肾和下腔静脉。此外，通过手可以最佳地放置肾脏，以便用血管吻合器离断肾血管。在离断肾静脉时，将吻合器置于下腔静脉壁上，以获得最大长度。当有适应证时，该技术已使HAL右侧供肾肾切除术能够安全实施。
