Single-port live donor nephrectomy using a novel Curved Radius R2 Surgical System in an in vivo model

Abstract

Objective: Single-port laparoscopic donor nephrectomy provides low morbidity and satisfactory cosmetic results for patients. The aim of this animal study was to establish a surgical technique of single-site (LESS) living donor nephrectomy using novel curved r2 CURVE manipulators specially designed for single-port access. Material and methods: A total of six LESS nephrectomies were performed in three female pigs. r2 CURVE-instruments (Tuebingen Scientific Medical GmbH) were used providing a curved rotatable shaft, endless tip rotation, as well as 90° tip deflection. A 10 mm 30° extra long laparoscope, r2-curved Grasper, Maryland dissector and bipolar scissors were used for mobilization and dissection. Results: All LESS nephrectomies were performed successfully. Average operative time was 80 min (range, 42–149 min). No technical problems were observed. Insertion and extraction of the instruments through the single-port were easy to conduct. The diameter of the used single-port was sufficient for safe manual organ harvesting. Potential conflict between the laparoscope and the instrument handles was avoided by using an extra long laparoscope. Conclusions: The new curved and deflectable instruments showed that single-port nephrectomy using the R2 manipulators is feasible. Single-port laparoscopic nephrectomy might be more patient-friendly and improve the willingness of potential donors to donate live organs.

Key words:

• Curved Radius Surgical System
• laparoscopic
• live donor nephrectomy
• experimental
• pig study

Declaration of interest: Marc Schurr has an equity interest in Tuebingen Scientific. All other authors certify that they have no commercial associations that might pose a conflict of interest in connection with the submitted article. There are no financial funding sources supporting the work: Instruments were provided by Tuebingen Scientific without cost for the study. All institutional or corporate affiliations are acknowledged in the article.