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  • Rhode Island Hospital Living Donor Transplant Program Kidney 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:

    1. A shorter hospital stay
    2. Decreased need for pain medication
    3. Earlier return to activities of daily living
    4. Earlier return to work

    Disadvantages

    1. 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.
    2. The requirement for blood transfusions has been slightly higher for those undergoing the laparoscopic procedure.
    3. 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