Renal Hilus Ligation With Single Stapler in Laparoscopic Donor Nephrectomy

• Published in: Transplantation proceedings 2019-09, Vol.51 (7), p.2225-2227
• Main Authors: Tokaç, Mehmet, Eren, Eryiğit, Özçelik, Ümit, Şahin, Taylan, Dinçkan, Ayhan
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Kidney - blood supply; Kidney Transplantation; Laparoscopy - methods; Ligation - instrumentation; Ligation - methods; Living Donors; Male; Middle Aged; Nephrectomy - methods; Operative Time; Renal Artery - surgery; Retrospective Studies; Surgical Stapling - instrumentation; Surgical Stapling - methods; Tissue and Organ Harvesting - methods
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2019.02.045

Ligation of renal hilus is the most important stage of laparoscopic donor nephrectomy. Laparoscopic staplers are securely used for renal pedicle control. We present our donor nephrectomy cases in which we used 1 stapler for renal artery and vein ligation. Demographic data, number of arteries and veins, ligation types, operation time, and complication rates are recorded. One hundred twenty laparoscopic donor nephrectomy cases who were operated between December 2017 and August 2018 in İstinye University Hospital and İstanbul Aydın University Hospital were retrospectively evaluated. All of the operations were done by 2 surgeons with a fully laparoscopic method. None of the cases were converted to open nephrectomy. There was 1 renal artery in 110 (91.7%) cases, 2 renal arteries in 9 (7.5%) cases, and 3 arteries in 1 (0.8%) case. Renal artery and vein were ligated with single stapler in 115 (95.8%) cases. Double stapler was used in 5 (4.2%) patients. There were no major complications for donors and no implantation problems for grafts. Laparoscopic donor nephrectomy is the most used technique for living donor operations. Vascular stapler is securely used for renal artery and vein ligation with high costs. Two or, due to the number of vessels, sometimes 3 staplers are used in the standard technique. In our study, the operation was finished securely in 95.8% of the patients with single stapler use. Single stapler use for ligating renal hilus is safe in kidneys even with suitable multiple arteries and veins in laparoscopic donor nephrectomy. •Laparoscopic donor nephrectomy is feasible with 3 trocars for both sides.•95.8% of laparoscopic donor nephrectomies were finished with single stapler.•Single stapler use for multiple arteries and veins in laparoscopic donor nephrectomy is feasible.•Single stapler use is fast, secure, feasible, and cost-effective in laparoscopic donor nephrectomy.