Department of General Surgery, Division of Transplantation, Demiroglu Bilim University, Istanbul, Turkey.
Center for Organ Transplantation, Medipol University, Istanbul, Turkey.
Transpl Int. 2021 Mar;34(3):445-454. doi: 10.1111/tri.13806. Epub 2021 Feb 26.
The introduction of laparoscopic donor nephrectomy caused a shift toward' left donor nephrectomy. Some centers report a significantly low rate of endoscopic right donor nephrectomy. Hand-assisted retroperitoneoscopic donor nephrectomy (HARP-DN) was introduced as a novel surgical technique, which aims to avoid intra-abdominal complications. It was also reported to provide technical advantages for right-sided DN. In this retrospective single-center study, we evaluated the impact of HARP-DN technique on utilization of right-sided DNs. After the implementation of HARP-DN on February 2009, a total of 565 DNs were performed until December 2015. The introduction of HARP-DN technique resulted in an immediate increase in the utilization of right kidneys from 6.1% to an average of 19.6% annually. The donors 'outcome was similar to the left-sided and right-sided DN groups, excluding the increased incidence of incisional hernias in left kidney donors. None of the donors developed intra-abdominal complications. In conclusion, the implementation of HARP technique significantly increased the use of right-sided DNs, which enables a more liberal use of donors in LDKT.
腹腔镜供肾切取术的引入导致了“左供肾切取术”的转变。一些中心报告称，内镜右供肾切取术的比例明显较低。手助经腹膜后腹腔镜供肾切取术（HARP-DN）作为一种新的手术技术被引入，旨在避免腹腔内并发症。它也被报道为右侧 DN 提供了技术优势。在这项回顾性单中心研究中，我们评估了 HARP-DN 技术对右侧 DN 应用的影响。在 2009 年 2 月实施 HARP-DN 后，直到 2015 年 12 月，共进行了 565 例 DN。HARP-DN 技术的引入立即使右肾的利用率从 6.1%增加到平均每年 19.6%。供者的结果与左侧和右侧 DN 组相似，左侧供肾者切口疝的发生率增加除外。没有供者发生腹腔内并发症。总之，HARP 技术的实施显著增加了右侧 DN 的应用，这使得 LDKT 中可以更自由地使用供者。
