Retroperitoneoscopic live donor nephrectomy: 7 cases.

Laparoscopic living donor nephrectomy causes less pain, shorter hospital stays and a quicker return to daily activities. Because of potential bowel injuries and risk of intestinal obstruction secondary to adhesions later on, the retroperitoneoscopic donor nephrectomy (RDN) technique has been developed. The first 7 RDN cases carried out at our organ transplantation unit between December 2006 and May 2007 were retrospectively examined. The male/female ratio of the patients was 4/3. Left nephrectomy was performed in all cases. In two patients, the conventional method was performed because of an adhesion in the hilar area in one patient and because of technical difficulty after entering the peritoneum in another patient. Serious complications such as massive hemorrhage and intestinal injury were not observed. None of the patients required blood transfusion. The mean operative time was 161 minutes, with the exception of 2 patients who required conversion to other methods. Mean warm ischemia duration was 125 seconds. Oral feeding began the first postoperative day. The mean inpatient stay was 3.5 days. The mean recipient creatinine levels 24 hours and 1 month post-procedure were 3.78 mg/dl and 1.04 mg/dl, respectively. RDN is technically more difficult and has a steeper learning curve compared to transperitoneal donor nephrectomy. As our RDN cases increase, we will obtain more representative data on complications.