Introduction: Laparoendoscopic single-site donor nephrectomy (LESS-DN) emerged as an advancement to standard laparoscopic surgery with its advantage of using a single small incision concealed in the umbilical scar as the operative as well as extraction port. LESS-DN can reduce donor morbidity and improve donor satisfaction with better cosmetic results. Aim: To present our experience with trans-umbilical LESS DN. Methods: retrospective study of data from 110 consecutive LESS DN donors and their recipients. Standard laparoscopic instruments were used in all patients. All cases had left sided nephrectomy and no exclusion criteria were used.Results: From 05/2015 to 11/2016, 110 LESS DN were performed by a single surgeon. The mean operative time was 175.9 ± 24.9 minutes and the mean warm ischemia time was 5.2± 1.02 mins. Mean body mass index was 24.8 ± 4.5 kg/m². Complex vascular anatomy (multiple arteries/veins or retro-aortic vein) was found in 40 patients (36.3%). Pure LESS-DN was successfully completed in 96 patients(87.2%).Due to technical difficulties, additional one or two 5 mm port(s) were added in 9 and 5 cases respectively. There was no conversion to open surgery in any patient. Two donors required re-exploration in the first postoperative week for picture of small bowel obstruction. All recipients had immediate graft function postoperatively. The mean recipient serum creatinine levels were 1.3±0.93 mg/dl, 1.1±0.33 mg/dl, 1.05±0.29 mg/dl at 7, 30 and 90 days after transplantation, respectively. Two recipients required reoperation for post operative bleeding. Conclusions: Our experience with LESS-DN is very encouraging. LESS-DN can be integrated as a standard approach for renal donation without additional donor risk and without compromising recipient outcomes, while potentially providing greater patient satisfaction and cosmetic outcomes. Moreover, in case of technical difficulties, the procedure can be easily converted to conventional laparoscopy (or even hand assist laparoscopy) by the addition of one or two 5mm ports.

CITATION INFORMATION: El Hennawy H, Fahmy A. Donor and Recipient Outcomes with Trans-Umbilical Laparoendoscopic Single-Site Donor Nephrectomy. Am J Transplant. 2017;17 (suppl 3).

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