Hand-assisted laparoscopic nephrectomy for a kidney transplant: surgical technique—tips and tricks—how we do it?

Abstract

: Kidney transplant is considered the best therapy for patients with chronic kidney disease in renal replacement therapy or dialysis stage, which has better survival and quality of life with lower morbidity and lower long-term expenses, resulting in overall cost saving for the health care system compared to other therapies. In a living donor kidney transplant patient, the safety must remain as maximal priority because it is performed on a healthy patient who accepts the risks of major surgery for the benefit of the recipient. The process of donation should be as least traumatic, painful, and uncomfortable as possible to the potential donor. Over the years several approaches have been described, currently there is no gold standard to perform a nephrectomy on potential donors. Hand-assisted laparoscopic nephrectomy encompasses the benefits of the minimally invasive approach reducing the operative time and learning curve in comparison with the totally laparoscopic procedure. This technique has shown excellent results, both for the donor and the recipient. This work presents the technical description of the hand-assisted laparoscopic nephrectomy focused on the anatomical aspects, tips and tricks. Furthermore, the equipment preference card, patient’s workup, postoperative management, and narrated technique video are added so that the reader can follow them visually.