Rhode Island Hospital
Living Donor Transplant Program
Donor Guide
Surgery Options: Laparoscopic Kidney Removal
Some donors may qualify for an alternate procedure, the laparoscopic
donor nephrectomy. This surgical approach takes approximately three
to four hours.
The procedure
In order to perform a laparoscopic donor nephrectomy, 3 to 4 small
incisions are made. The abdomen is inflated with a gas that allows
movement and separation of the abdominal organs. Surgical instruments
and a laparoscope are inserted through the small incisions, which
allows the surgeon to maneuver around the organs and see and remove
the kidney. The kidney is removed through a small incision above
the pubic area.
Advantages
The advantages of the laparoscopic technique are:
- A shorter hospital stay
- Decreased need for pain medication
- Earlier return to activities of daily living
- Earlier return to work
Disadvantages
- The complication rate has been reported to be slightly higher
than that of the traditional open donor nephrectomy. Some have
reported a higher incidence of surgical damage to the blood vessels
and ureter.
- The requirement for blood transfusions has been slightly higher
for those undergoing the laparoscopic procedure.
- It has also been reported that the recipient's risk of delayed
kidney function is higher due to decreased blood flow to the kidney
when gas is placed in the abdomen, and the trauma to the kidney
when it is removed from the small incisions. This may lead to
a slow return of kidney function when the kidney is transplanted
into the recipient. If this does occur, the recipient is not able
to start normal doses of immunosuppressive medication as quickly,
which may account for higher incidence of rejection of the kidney
after surgery.
The complication rate has reportedly decreased over the past three
years as transplant surgeons have gained more expertise with the
laparoscopic procedure.
Donors who do not qualify for the laparoscopic procedure,
will have the traditional, open surgery.
The surgeon will be able to discuss surgical options in detail during
the office visit. There are advantages and disadvantages to both
procedures.
Recovering from surgery 
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