Retroperitoneal Single-port Donor Nephrectomy through Lumbotomy Incision: An Experience of 30 Cases

Ab s t r Ac t Introduction: Over the years, laparoscopic donor nephrectomy (LDN) has evolved as a preferred alternative to open-donor nephrectomy (ODN). Laparoscopic donor nephrectomy can be performed either by transperitoneal or retroperitoneal route. Retroperitoneoscopic live donor nephrectomy (RPLDN) results in less analgesic requirement, decreased hospital stay, and better cosmetic acceptance by the donors. Lumbotomy incision has been thought to be an ideal approach without any muscle being cut but is limited by the amount of space in open surgery. Materials and methods: Between November 2014 and September 2016, 350 donor nephrectomies were performed at our department. All the surgeries were performed by a single surgeon. Thirty patients consented for translumbar RPLDN out of the 82 donor nephrectomies assigned to that particular surgeon. Visual analog scale (VAS) was used to evaluate the severity of pain on postoperative day (POD)0 and POD1. Results: Mean age of donors was 44.7 ± 11.4 years, M:F ratio 9:21. Average duration of surgery was 170.33 ± 52 minutes. Four patients (13.3%) had double renal arteries and one patient had double renal vein. In one patient, retrieval was performed by an open approach. No patient had surgical site infection. Most patients (28/30) had a VAS score of <4, and did not require any additional analgesics beyond POD0. Conclusion: Single-site translumbar RPLDN is a feasible alternative approach to the donor surgery.