Laparoscopy for living donor left nephrectomy: Comparison of three-dimensional and two-dimensional vision

Clin Transplant. 2019 Dec;33(12):e13745. doi: 10.1111/ctr.13745. Epub 2019 Nov 13.

Abstract

The main objective of this preliminary study was to evaluate the feasibility and safety of 3-D laparoscopic living donor left nephrectomy (LDLN). The secondary objective was to compare intraoperative and postoperative outcomes between 3-D and 2-D laparoscopic LDLN. All patients who underwent a laparoscopic LDLN from January 2015 to April 2018 in a university center were included. All surgeries were performed by three experienced surgeons. Seventy three patients were included the following: 16 underwent a 3-D laparoscopic LDLN (3-D group), and 57 underwent a 2-D laparoscopic LDLN (2-D group). Operative time and warm ischemia time (WIT) were significantly lower in the 3-D group (operative time: 80.9 ± 10.2 vs 114.1 ± 32.3 minutes in the 3-D and 2-D groups, P = .0002) (WIT: 1.7 ± 0.6 vs 2.3 ± 0.9 minutes in the 3-D and 2-D groups, P = .02). No conversion to open surgery occurred in both groups. Length of hospital stay was significantly shorter in the 3-D group. No major postoperative complications (Clavien ≥ III) occurred. One-year postoperative GFR was similar to 3-D and 2-D groups. Our preliminary study demonstrates that 3-D laparoscopic LDLN is a feasible and safe surgical procedure. Intraoperative and postoperative outcomes were similar in both 2-D and 3-D vision systems, but 3-D vision systems allow reduction in WIT and operative time.

Keywords: laparoscopic living donor nephrectomy; operative time; three-dimensional laparoscopy; warm ischemia.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Transplantation / methods*
  • Laparoscopy / instrumentation*
  • Laparoscopy / methods*
  • Length of Stay
  • Living Donors / supply & distribution*
  • Male
  • Middle Aged
  • Nephrectomy / methods*
  • Prognosis
  • Retrospective Studies
  • Tissue and Organ Harvesting / methods*
  • Warm Ischemia