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Left Laparoscopic Donor Nephrectomy

Tatsuo Kawai, MD
Massachusetts General Hospital

1. Introduction

2. Incision and Port Placement

  1. Perform Pfannestiel Incision
  2. Insert Hand Port and Create Pneumoperitoneum
  3. Mark Locations for Ports
  4. Insert Tracers Under Laparoscopic Guidance

3. Left Colon Mobilization

4. Left Kidney Exposure and Mobilization

  1. Dissect Gerona's Fascia
  2. Expose and Mobilize Lower Pole
  3. Identify and Dissect Left Ureter
  4. Mobilize Upper Pole

5. Left Renal Hilum Dissection

  1. Dissect Renal Vein
  2. Ligate and Transect Gonadal Vein
  3. Ligate and Transect Adrenal Vein
  4. Dissect Renal Artery
  5. Dissect Posterior Aspect of Renal Vein
  6. Ligate Lumbar Veins

6. Left Kidney Extraction

  1. Ligate and Transect Left Ureter Distally
  2. Place Kidney in Endo Catch
  3. Staple and Transect Renal Artery Proximally
  4. Staple and Transect Renal Vein Proximally
  5. Remove Kidney

7. Reperfusion of Kidney

8. Closure

  1. Assess For and Control Bleeding
  2. Apply Precautionary Seal
  3. Reposition Colon
  4. Close Ports
  5. Close Pfannenstiel Incision