A Fast and Safe Living Donor "Finger-Assisted" Nephrectomy Technique

Introduction: A living-related donor offers advantages to the recipient: Shorter delay between renal failure and rehabilitation and immediate post-transplant renal function and smaller doses of immunosuppressive drugs.Utmost caution must be exerted not to harm or diminish the renal reserve of a healthy volunteer.“Finger Assisted” nephrectomy technique: The patient rolled into the lateral position with the tip of the 11th rib directly overlying the kidney-rest on the operating table.After the patient is secured, the table is flexed so that there is the greatest possible separation between iliac crest and lower costal margin.The incision is made (5±1cm along the 11th rib). The kidney is exposed from pole to pole and from its greater curvature to the hilum both anteriorly and posteriorly. The ureter and its attachments are also exposed and stapled with the ETS-FLEX (articulating endoscopic Linear vascular cutter). After the hilum has been cleaned so that only the renal vein and renal artery remain, these vessels are also stapled with the ETS-FLEX.Results: Over 850 Mini-open Donor Nephrectomy 2000 -2014 with no significant complicationsThis procedure is safe, applicable in all potential donors regardless of the BMI or the size of the hands of the surgeon, gives excellent grafts and allowed the expansion of our living donor program > 70%.