2076 LAPAROENDOSCOPIC SINGLE-SITE VERSUS CONVENTIONAL LAPAROSCOPIC DONOR NEPHRECTOMY

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery I1 Apr 20102076 LAPAROENDOSCOPIC SINGLE-SITE VERSUS CONVENTIONAL LAPAROSCOPIC DONOR NEPHRECTOMY Soroush Rais-Bahrami, Amin Herati, Nikhil Waingankar, Sero Andonian, Mohamed Atalla, Michael Schwartz, Lee Richstone, and Louis Kavoussi Soroush Rais-BahramiSoroush Rais-Bahrami More articles by this author , Amin HeratiAmin Herati More articles by this author , Nikhil WaingankarNikhil Waingankar More articles by this author , Sero AndonianSero Andonian More articles by this author , Mohamed AtallaMohamed Atalla More articles by this author , Michael SchwartzMichael Schwartz More articles by this author , Lee RichstoneLee Richstone More articles by this author , and Louis KavoussiLouis Kavoussi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2136AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES LaparoEndoscopic Single-site Surgery (LESS) focuses on minimizing the incisions used for laparoscopic access. This has been adopted for laparoscopic living donor nephrectomy. We hypothesize that LESS will offer superior cosmetic outcomes, faster recovery, and equivalent efficacy as conventional laparoscopy. Our aim is to present our experience comparing a contemporary series of conventional laparoscopic donor nephrectomy to LESS donor nephrectomy comparing perioperative parameters and postoperative pain. METHODS Data was prospectively gathered on 35 patients undergoing both conventional (n=24) and LESS (n=11) donor nephrectomy at our institution between January 2008 and November 2009. LESS donor nephrectomy was performed through a single Pfannensteil skin incision through which a 12mm and two 5mm trocars were introduced. Otherwise, the procedure replicated conventional laparoscopic techniques, using a 5mm flexible-tip laparoscope, and combining flexible with conventional working instruments including a LigaSure device and EndoGIA stapler. RESULTS Patient characteristics and perioperative parameters stratified by operative approach are shown in Table #1. The two treatment cohorts had similar age, ASA, and BMI. There was no difference in any perioperative parameter investigated. No patients required intraoperative or postoperative blood transfusions. Operative Approach p-value Conventional LESS Age (yrs) 37.0±13.2 41.9±11.3 0.29 ASA 1.6±0.6 1.5±0.5 0.65 BMI (kg/m2) 26.8±4.3 28.6±5.3 0.30 Operative Time (min) 127±31 144±42 0.22 Warm Ischemia Time (min) 4.9±1.6 5.1±2.0 0.86 Estimated Blood Loss (mL) 200±217 107±37 0.17 Length of Hospitalization (days) 2.3±0.6 2.3±0.6 0.89 Postoperative Morphine Equivalents Used (mg) 59.8±26.4 58.9±39.0 0.94 CONCLUSIONS LESS donor nephrectomy has equivalent operative time, blood loss, warm ischemia, and length of hospitalization when compared to conventional laparoscopic donor nephrectomy. In our early experience, patients undergoing LESS donor nephrectomy have similar postoperative analgesic requirements combining their inpatient narcotic and intravenous ketorolac use. Further evaluation of these findings is currently underway in a randomized, blinded study. New Hyde Park, NY© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183 Issue 4S April 2010 Page: e807 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Metrics Author Information Soroush Rais-Bahrami More articles by this author Amin Herati More articles by this author Nikhil Waingankar More articles by this author Sero Andonian More articles by this author Mohamed Atalla More articles by this author Michael Schwartz More articles by this author Lee Richstone More articles by this author Louis Kavoussi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...