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Laparoscopic Donor Nephrectomy Procedure in Mukundapur

Laparoscopic Donor Nephrectomy

Laparoscopic Donor Nephrectomy Procedure in Mukundapur

A Donor Nephrectomy involves surgically removing a healthy kidney from a living donor for transplantation into someone with kidney failure, offering them a chance to regain kidney function and potentially avoid Dialysis. Compared to Dialysis, which filters waste from the blood using machines or peritoneal methods, Kidney Transplantation is preferred for its effectiveness and long-term benefits. Living-donor kidneys typically offer superior outcomes over deceased-donor organs, functioning immediately after transplant and often lasting longer. Laparoscopic Donor Nephrectomy, utilising minimally invasive techniques like small incisions and a camera (laparoscope), enhances recovery times, reduces post-operative discomfort, and shortens hospital stays compared to traditional open surgery.

The procedure is safe when performed by experienced surgeons after thorough donor evaluation to ensure long-term kidney health. Overall, Laparoscopic Donor Nephrectomy in Mukundapur is the preferred method for enhancing both donor recovery and the effectiveness of Kidney Transplantation.  

 

FAQ's

Indications of Laparoscopic Donor Nephrectomy:

  • Minimal Invasive Surgery: Laparoscopic Donor Nephrectomy is preferred due to its minimally invasive nature compared to traditional open surgery.

  • Donor Safety: Suitable for donors who meet general criteria for kidney donation, ensuring safety and minimal post-operative discomfort.

  • Rapid Recovery: Allows for quicker recovery times compared to open surgery, enabling donors to return to normal activities sooner.

Contraindications of Laparoscopic Donor Nephrectomy:

  • Complex Anatomy: While advancements have expanded eligibility, donors with complex kidney anatomy (e.g., multiple vessels or unusual vasculature) may still pose challenges.

  • Obesity: Donors with obesity may have higher surgical risks due to technical difficulties associated with laparoscopic procedures.

  • Prior Abdominal Surgeries: Previous Abdominal surgeries can be a relative contraindication, particularly if attempting a different approach (e.g., Retroperitoneal vs Transperitoneal surgery).

  • Laparoscopic Nephrectomy is done with the patient in a modified flank position and under general endotracheal anaesthesia.

  • The kidney is approached via transperitoneal access using four port sites.

  • One port site (1 cm) is enlarged for kidney removal.

  • The transperitoneal route provides ample space for dissection and allows for addressing other surgical issues if needed.

  • The kidney is freed from surrounding attachments, and the artery and vein branches are exposed.

  • Once the kidney is dissected, a bolus of heparin is administered.

  • A gastrointestinal anastomosis stapler is used to cut and secure the renal artery and vein.

  • The kidney is extracted through an expanded fourth site.

  • The extracted kidney is flushed and prepared for transplantation.

  • Incisions are closed, and the laparoscopic procedure is concluded in a standard manner.

Major complications from the surgery involve:

  • Postoperative retroperitoneal bleeding that required a transfusion

  • Stapler malfunction that necessitated an emergency open conversion

  • Epigastric artery damage

  • Injury to the bowel

  • Pneumonia occurrence

  • Incisional hernia development

Minor complications include:

  • Temporary tingling or numbness in the thigh

  • Superficial wound infection or fluid collection

  • Urinary tract infections

  • Respiratory issues such as mucus plugs or partial lung collapse

  • Extended recovery time for the intestines

  • Inflammation of the epididymis

Recovery tends to be faster compared to open surgery. Most individuals can leave the hospital within a few days and return to regular activities in a couple of weeks. Follow-up appointments are necessary to oversee recovery and manage any possible issues.
 

Laparoscopic Donor Nephrectomy is usually safe for the donor when an experienced surgeon performs the procedure. The risks are generally lower than those of open surgery, although careful monitoring for potential issues is still necessary.
 

Surgeons often opt to remove the left kidney because it provides a more suitable venous and arterial length for transplantation. However, the decision may vary depending on the specific anatomy and condition of each kidney and the surgeon's clinical judgement for the individual case.
 

Preoperative imaging typically includes ultrasound, CT scans, or MRIs to assess kidney function, size, and anatomy. These tests help determine the suitability of the kidney for donation and identify any potential issues.
 

Preoperative preparations include medical evaluations, blood tests, and imaging studies. Patients may need to stop certain medications and fast before surgery. Psychological evaluations may also be conducted to ensure the donor is ready for the procedure.

The procedure usually takes between 2 to 4 hours, depending on the complexity of the case and the patient's anatomy.
 

Donors should maintain their health by following a balanced diet, staying hydrated, and engaging in regular exercise. They should also attend follow-up visits and take any prescribed medications.
 

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