A randomized, prospective study of laparoendoscopic single-site plus one-port versus mini laparoscopic technique for live donor nephrectomy.
Lee KW, Choi SW, et al.World Journal of Urology 2018; 02: 02.
Aims
To compare laparoendoscopic single-site plus one-port donor nephrectomy (LESSOP-DN) with mini laparoscopic donor nephrectomy (MLDN) in living kidney donors.
Interventions
Participants were randomised to receive either LESSOP-DN performed through a single periumbilical incision measuring 3–3.5 cm using a GelPOINT™ platform, an additional 12-mm port for the other working channel at the lateral abdominal wall, a 12-mm trocar for the operating instrument and an 11-mm trocar for the camera, versus MLDN perfomed with a Pfannenstiel incision measuring 4–5 cm, a SurgiTractor, one 11-mm umbilical trocar for the camera and two 5-mm trocars for operating instruments.
Participants
99 living kidney donors scheduled for left donor nephrectomy.
Outcomes
The primary outcome measured was donor satisfaction with cosmesis, assessed using a body image questionnaire 6 months after surgery. Secondary measured outcomes included donor and recipient perioperative data, donor subject questionnaires, and recipient outcomes.
Follow-up
6 months
CET Conclusions
This manuscript reports an RCT comparing mini-laparoscopic donor nephrectomy (a modification of standard LDN) with laparoscopic single-site plus one-port donor nephrectomy (LESSOP-DN) in a single centre. Despite a shorter total incision length and shorter time to extraction in the LESSOP-DN arm, pain scores, body image and complication/conversion rates did not differ between the groups. It is hard to know exactly how to interpret these data as all operations were performed by a single surgeon at one centre, using unconventional techniques. The experience of the surgeon is not documented, so exactly where they are on the learning curve for both operations is not clear. How generalisable the findings are to other centres is therefore difficult to determine, but it does appear that both techniques are safe and have similar outcomes.
Data analysis
Modified intention-to-treat analysis
Trial registration
None