Erfaringer med laparoskopisk donornefrektomi på Herlev Hospital

INTRODUCTION: The purpose of this investigation was to evaluate the morbidity and convalescence of donors after laparoscopic nephrectomy. Transperitoneal laparoscopy was initiated at Herlev University Hospital in November 2002.

MATERIALS AND METHODS: All 24 records from patients who underwent laparoscopic donor nephrectomy were reviewed. Demographic data and perioperative data were collected.

RESULTS: Median operation time was 162 min. Estimated blood loss was 200 ml and warm ischemia time 5 min. Postoperative side effects were nausea/vomiting (nine patients) and shoulder pain (two patients). Most serious complication was bleeding, leading to laparotomy the day of surgery in one patient. Other complications were ileus due to herniation of small intestine in porthole 1/24, wound infection 3/24, vaso-vagal episode 1/24, bronchospasms with CO2-retention 1/24, pneumonia 1/24. Length of stay was three days. Return to activities of daily life after 3-4 weeks. Typical analgesics were ketorolac and paracetamol. No laparoscopic procedures were converted to open surgery. There was no mortality. One year graft survival is 96%.

CONCLUSION: Transperitoneal laparoscopic donor nephrectomy can be performed safely without serious complications. It is a good alternative to the conventional open approach. No laparoscopic procedures were converted to open nephrectomy. These results are similar to experiences from large centres.