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Surgical Endoscopy

, Volume 24, Issue 11, pp 2755–2759 | Cite as

The feasibility of solo-surgeon living donor nephrectomy: initial experience using video-assisted minilaparotomy surgery

  • Yong Seung Lee
  • Hwang Gyun Jeon
  • Seung Ryeol Lee
  • Woo Ju Jeong
  • Seung Choul Yang
  • Woong Kyu HanEmail author
Article

Abstract

Background

Today, many kinds of surgery are being conducted without human assistants. Living donor nephrectomy (LDN) using video-assisted minilaparotomy surgery (VAM) has been performed by solo-surgeon using Unitrac® (Aesculap Surgical Instrument, Germany). We examined the results from VAM–solo-surgeon living donor nephrectomy (SLDN) and conventional VAM–human-assisted living donor nephrectomy (HLDN).

Methods

Between July 2007 and April 2008, 82 cases of VAM–LDN were performed by two surgeons. From these cases, we randomly assigned 35 cases to undergo solo-surgery (group I) and the other 47 cases to undergo surgery with one human assistant (group II). All VAM–LDN procedures were performed in the same manner. Only the roles of a first assistant were substituted by the Unitrac® in group I. We compared the perioperative and postoperative data, including operative time, estimated blood loss, and hospital stay, between the two groups. We also investigated cases that developed complications.

Results

There were no significant differences in the patient demographic data between the two groups (P > 0.05). The mean operative time was 201.9 ± 32.9 min in group I and 202.4 ± 48.3 min in group II (P = 0.954), whereas mean blood loss was 209.7 ± 167.3 ml in group I and 179.6 ± 87.8 ml in group II (P = 0.294). Postoperative hospital stay were 5.4 ± 1.1 days in group I and 5.5 ± 1.6 days in group II (P = 0.813). The incidence of perioperative complications was not significantly different between the two groups.

Conclusions

Our study demonstrates that VAM–SLDN can be performed safely, is economically beneficial, and is comparable to VAM–HLDN in terms of postoperative outcomes.

Keywords

Living donor nephrectomy Solo-surgery Kidney transplantation 

Notes

Disclosures

Y. S. Lee, H. G. Jeon, S. R. Lee, W. J. Jeong, S. C. Yang, and W. K. Han have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Partin AW, Adams JB, Moore RG, Kavoussi LR (1995) Complete robot-assisted laparoscopic urologic surgery: a preliminary report. J Am Coll Surg 181:552–557PubMedGoogle Scholar
  2. 2.
    Kavoussi LR, Moore RG, Adams JB, Partin AW (1995) Comparison of robotic versus human laparoscopic camera control. J Urol 154:2134–2136CrossRefPubMedGoogle Scholar
  3. 3.
    Flores RO, Zermeño JN, Martínez AM, Vera MG, Nieto Miranda JJ, Espinoza DL (2007) Laparoscopic Nissen solo surgery using PMAT (first experience). Minim Invasive Ther Allied Technol 16:347–349CrossRefPubMedGoogle Scholar
  4. 4.
    Kalteis M, Pistrich R, Schimetta W, Pölz W (2007) Laparoscopic cholecystectomy as solo surgery with the aid of a robotic camera holder: a case-control study. Surg Laparosc Endosc Percutan Tech 17:277–282CrossRefPubMedGoogle Scholar
  5. 5.
    Tanoue K, Yasunaga T, Kobayashi E, Miyamoto S, Sakuma I, Dohi T, Konishi K, Yamaguchi S, Kinjo N, Takenaka K, Maehara Y, Hashizume M (2006) Laparoscopic cholecystectomy using a newly developed laparoscope manipulator for 10 patients with cholelithiasis. Surg Endosc 20:753–756CrossRefPubMedGoogle Scholar
  6. 6.
    Yoshino I, Yasunaga T, Hashizume M, Maehara Y (2005) A novel endoscope manipulator, Naviot, enables solo-surgery to be performed during video-assisted thoracic surgery. Interact Cardiovasc Thorac Surg 4:404–405CrossRefPubMedGoogle Scholar
  7. 7.
    Rulli F, Galatà G, Pompeo E, Farinon AM (2007) A camera handler for Miccoli’s minimally invasive video-assisted thyroidectomy and parathyroidectomy procedures. Surg Endosc 21:1017–1019CrossRefPubMedGoogle Scholar
  8. 8.
    Yang SC, Ko WJ, Byun YJ, Rha KH (2001) Retroperitoneoscopy assisted live donor nephrectomy: the Yonsei experience. J Urol 165:1099–1102CrossRefPubMedGoogle Scholar
  9. 9.
    Rha KH, Kim YS, Kim SI, Byun YJ, Hong SJ, Park K, Yang SC (2004) Video-assisted minilaparotomy surgery (VAMS)–live donor nephrectomy: 239 cases. Yonsei Med J 45:1149–1154PubMedGoogle Scholar
  10. 10.
    Jaspers JE, Breedveld P, Herder JL, Grimbergen CA (2004) Camera and instrument holders and their clinical value in minimally invasive surgery. Surg Laparosc Endosc Percutan Tech 14:145–152CrossRefPubMedGoogle Scholar
  11. 11.
    Arezzo A, Schurr MO, Braun A, Buess GF (2005) Experimental assessment of a new mechanical endoscopic solo surgery system: endofreeze. Surg Endosc 19:581–588CrossRefPubMedGoogle Scholar
  12. 12.
    Antiphon P, Hoznek A, Benyoussef A, de lataille A, Cicco A, Elard S, Gettman MT, Katz R, Vordos D, Salomon L, Chopin DK, Abbou CC (2003) Complete solo laparoscopic radical prostatectomy: initial experience. Urology 61:724–728 discussion 728CrossRefPubMedGoogle Scholar
  13. 13.
    Drasin T, Dutson E, Gracia C (2004) Use of a robotic system as surgical first assistant in advanced laparoscopic surgery. J Am Coll Surg 199:368–373CrossRefPubMedGoogle Scholar
  14. 14.
    Kok NF, Adang EM, Hansson BM, Dooper IM, Weimar W, van der Wilt GJ, Ijzermans JN (2007) Cost effectiveness of laparoscopic versus mini-incision open donor nephrectomy: a randomized study. Transplantation 83:1582–1587CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Yong Seung Lee
    • 1
  • Hwang Gyun Jeon
    • 1
  • Seung Ryeol Lee
    • 1
  • Woo Ju Jeong
    • 1
  • Seung Choul Yang
    • 1
  • Woong Kyu Han
    • 1
    Email author
  1. 1.Department of Urology, Urological Science InstituteYonsei University College of MedicineSeoulKorea

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