الگوي مناسب از نفركتومي دهنده زنده لاپاروسكوپيك براي كشورهاي درحال توسعه

LAPAROSCOPIC LIVE-DONOR NEPHRECTOMY: A PATTERN FOR DEVELOPING COUNTRIES

Backgrounds & Aims : To describe pattern for laparoscopic live-donor nephrectomy (LLDN) to more cost-effective for developing countries: LLDN was developed as a better alternative to conventional donor nephrectomy, with advantages of an earlier return to normal activities and smaller scars, but is not popular in developing countries because of high cost of disposable items. Some modifications were done in Kidyney transplantation research center in Shahid Hashemi Nejad hospital in Tehran. Materials & Methods: From Sep. 2003 to Aug. 2004, 16 LLDN were performed by modified cost effective technique. In this procedure. Kidney was delivered through a 6 cm supra pubic midline incision by hand and clipping the hilum using ligaclips. Results: The mean age, operative duration, warm ischemia time, blood loss, analgesic requirements, hospital stay were recorded. Open conversion or Re-exploration was not required. Complications during procedure were seen in two patients (Mild spleen decapsulation). Immediate complications after surgery occurred in one patient (Atelectasia).Using endo clips; the cost was considerably reduced (%60). The suprapubic midline incision was aesthetically pleasing and more acceptable to patients. Conclusion: These modifications are relevant in the context of developing countries, as they provide all the benefits of LLDN at reduced cost and with better cosmetic results.