[Pararectal mini-incision for strictly retroperitoneal nephrectomy in living kidney donation]

Urologe A. 2006 Sep;45(9):1170-5. doi: 10.1007/s00120-006-1080-0.
[Article in German]

Abstract

Purpose: In this study we present the technique of a strictly retroperitoneal donor nephrectomy via a pararectal mini-incision.

Material and methods: Data of 34 living kidney donations were analyzed. All donors underwent a pararectal mini-incision and strictly retroperitoneal nephrectomy (MIDN).

Results: Total operation time, perioperative use of pain medication, length of hospital stay after successful mobilization, and return to full enteral nutrition and regular digestion were evaluated retrospectively. Total operation time for MIDN was 132+/-26 min. The total average application was 22.2+/-19.4 mg of opioid in morphine equivalent dosage (MED), 7.7+/-6.1 g metamizol, and 512+/-325 mg NSAR during hospital stay, which was 4.9+/-1.4 days. Patients were mobilized primarily 2.9+/-8.0 h after surgery. Mobility was achieved 33.8+/-15.8 h after surgery. Enteral nutrition with fluids was started after 1.9+/-7.0 h, full enteral nutrition was accomplished after 37.4+/-19.0 h, and normal digestion returned 58.6+/-23.0 h after the procedure.

Conclusions: The strictly retroperitoneal nephrectomy via a mini-incision is an elegant, minimally traumatic, safe, and quickly learnable method, resulting in short hospital stays, good cosmetic results, and a low grade of complications.

MeSH terms

  • Adult
  • Aged
  • Early Ambulation
  • Enteral Nutrition
  • Female
  • Humans
  • Length of Stay
  • Living Donors*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Nephrectomy / methods*
  • Outcome and Process Assessment, Health Care
  • Pain, Postoperative / etiology
  • Postoperative Care
  • Postoperative Complications / etiology
  • Rectum / surgery
  • Retroperitoneal Space / surgery
  • Retrospective Studies