Difficulties in Laparoscopic and Robotic Living Donor Nephrectomy
End stage renal disease (ESRD) is a leading cause of morbidity and death among Americans and represents a significant financial burden to the health care system of the United States. Traditionally, renal replacement therapy has come in the form of hemodialysis or renal transplantation. Certainly, the latter is associated with not only significantly better longevity but also a tangibly improved quality of life. Unfortunately, the pervasiveness of hypertensive and diabetic nephropathy in the western culture has disproportionately exceeded the supply of available allografts. Within the context of this mounting shortage, the rate of deceased donor renal transplants has remained relatively stagnant. As a consequence, there exists a distinct and pressing need for increased accrual of living kidney donors. This chapter describes the technicalities and difficulties of the procedure.
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