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Laparoscopic Donor Nephrectomy-Radical Approach in Obese Donors

Adarsh Vijay*, Matthew Cooper and Seyed Reza Ghasemian
Department of Transplant Surgery, Georgetown Transplant Institute, Washington DC, USA


*Corresponding author: Adarsh Vijay, Department of Transplant Surgery, Georgetown Transplant Institute, Washington DC, USA


Published: 26 Feb, 2018
Cite this article as: Vijay A, Cooper M, Ghasemian SR. Laparoscopic Donor Nephrectomy- Radical Approach in Obese Donors. Clin Surg. 2018; 3: 1920.

Keywords

Donor nephrectomy; Obese; Radical approach

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Acceptance of obese individuals as living kidney donors is controversial. Owing to increasing prevalence of obesity in the general population and ever increasing demand for organs, obese donors comprise 25% of the donor pool [1]. Studies have reported obese donors to be more technically challenging with increased operative time and longer hospital stay. We report an alternative technique to the usual laparoscopic donor nephrectomy. In obese donors, we propose a radical approach whereby we leave the gerota's fascia and perirenal cushion of fat intact (Figure 1). By avoiding mobilization within the gerota’s fascia, we reduce the chances of bleeding, thermal injury to the graft and fat planes obscuring surgical view. The adrenal gland is not excised. This radical approach in obese individuals enables faster retrieval of the graft without compromising on safety and precision.

Figure 1

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Figure 1
Laparoscopic Donor Nephrectomy-Radical Approach.

References

  1. Sachdeva M, Rosen LM, Varghese J, Fishbane S, Molmenti EP. Weight trends in United States living kidney donors: Analysis of the UNOS database. World J Transplant. 2015;5(3):137-44.