LAUSR

Introduction We present our initial experience with 22 consecutive patients underwent hand assisted laparoscopic living donor nephrectomy by a skilled gastrointestinal surgeon. Methods From December 2014 to January 2017, a total 22 kidney transplantation donor was enrolled in this study. All clinical data such as demographics, perioperative data and graft profiles was collected prospectively and analyzed retrospectively. Results Right kidney was harvested in 12 patients. Mean operative time was 235.0±41.9 min (range 140‐300 min) and intraoperative blood loss was 293.2±203.1 ml (range 50‐700 ml). Mean warm ischemic time was 291.7±108.6 sec (range 179‐610 min). Postoperative complications included chyle leakage in 2 patients who were left kidney donor, oliguria in 1 patient who was right kidney donor. All cases were recovered with conservative care and mean hospital stay was 7.5±1.7 days. Mean creatinine was 0.7±0.2 before surgery, 1.1±0.3 in POD 1 and 1.0±0.2 after discharge. Mean GFR (MDRD) was 97.9±18.2 before surgery, 60.7±10.4 in POD 1 and 67.3±11.1 after discharge. Operation time was no associated with patient’s body mass index and there was no correlation between operation time and case number. There were no significant differences of perioperative data between the side of kidney except the postoperative complication. Conclusion Skilled surgeon who has experience of laparoscopic abdominal surgery may safely perform hand assisted donor nephrectomy. However, we could not identify clear case number to complete the learning curve.