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Urol Ann. 2015 Jul-Sep;7(3):361-5. doi: 10.4103/0974-7796.160321.

LESS living donor nephrectomy: Surgical technique and results.

Urology annals

Abdullah Alessimi, Emilie Adam, Georges-Pascal Haber, Lionel Badet, Ricardo Codas, Hakim Fassi Fehri, Xavier Martin, Sébastien Crouzet


  1. Department of Urology and Transplantation Edouard Herriot Hospital, Lyon, France.
  2. Center for Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

PMID: 26229326 PMCID: PMC4518375 DOI: 10.4103/0974-7796.160321


PURPOSE: We present the findings of 50 patients undergoing pure trans-umbilical laparo-endoscopic single-site surgery (LESS) living donor nephrectomy (LDN), between February 2010 and May 2014.

MATERIALS AND METHODS: Laparo-endoscopic single-site surgery LDN was performed through an umbilical incision. Different trocars were used, namely Gelpoint (Applied Mιdical, Rancho Santa Margarita, CA) SILS port (Covidien, Hamilton, Bermuda), R-port (Olympus Surgical, Orangeburg, NY) and standard trocars, inserted through the same skin incision but using separate fascial punctures. The standard laparoscopic technique was employed. The kidney was pre-entrapped in a retrieval bag and extracted trans-umbilically. Data were collected prospectively including questionnaires containing patient reported oral pain medication duration and time to recovery.

RESULTS: LESS LDN was successful in all patients. Mean warm ischemia time was 6.2 min (3-15), mean procedure time was 233.2 min (172-300), and hospitalization stay was 3.94 days (3-7) with a visual analogue pain score at discharge of 1.32 (0-3). No intraoperative complications occurred. The mean time of oral pain medication was 8.72 days (1-20) and final scar length was 4.06 cm (3-5). Each allograft was functional.

CONCLUSION: Although challenging, trans-umbilical LESS LDN seems to be feasible and safe. Hence, LESS has the potential to improve cosmetic results and decrease morbidity.

Keywords: Laparo-endoscopic single-site surgery; laparoscopy; living donor nephrectomy; minimally invasive; single port


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