Ergonomics during live kidney donation: Two surgical approaches compared

Each year the number of patients with chronic kidney failure waiting for transplantation increases. In 2007, approximately 500 candidates for kidney transplantation died while being on the waiting list in the Eurotransplant countries and more than 4000 candidates died in the United States. Live kidney donation is the most realistic option to reduce donor shortage on the short and long term. In the last decade the number of non-related live kidney donations is rising. Among these donors are family and friends of the recipient/patient, and even anonymous donors. The surgical removal of kidney is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee safety for the donors, it is important to optimize the surgical approach continuously. The surgical practice has evolved from an open surgical approach, through mini-incision open donor nephrectomy, to minimally invasive laparoscopic techniques. The minimally invasive techniques differ from the standard laparoscopic donor nephrectomy, hand-assisted techniques, retroperitoneal technique and robotic-assisted donor nephrectomy. Literature shows sufficient evidence that minimally invasive techniques are preferred above open and mini-incision donor nephrectomy because of the advantages for the donor such as, less blood loss, shorter hospitalization, less morphine, and better cosmetic results.