To investigate the safety of right-sided retroperitoneal laparoscopic living related donor nephrectomy and summarize the relevant clinical experience.

Retrospective analysis was performed on the clinical data of 14 cases of living related donor renal resection performed in the Institute of Organ Transplant of the 8th Medical Center of PLA General Hospital from February 2010 to June 2019. Among which 8 cases were performed with retroperitoneal laparoscopic renal resection (laparoscopic group) and 6 cases were performed via lumbar open renal resection (open surgery group). All the donors were routinely placed in the left lateral decubitus position and the waist was punctured with 3 trocars. Group t test was used to compare the operative time, the suture time of vena cava incision, the length of the donor renal artery, the length of the donor renal vein, the duration of hot ischemia, the amount of bleeding and the postoperative hospital stay of the two groups. P<0.05 was considered statistically significant.

All the living related donor nephrectomy were successfully performed. No blood transfusion was performed in the two groups, and no laparotomy was performed in the laparoscopic group. The length of donor renal vein in the laparoscopic group and the open surgery group was (2.2±0.4) and (1.2±0.3) cm, and the intraoperative blood loss was (45±12) and (80±10) mL, respectively, with statistically significant differences (t=1.042 and 5.781, P all<0.05). There was no statistically significant differences between the two types of surgery in terms of operative time, cava incision suture time, donor artery length, donor kidney hot ischemia time and postoperative hospital stay time (P all>0.05). As of August 2019, the median follow-up time of donors of the open surgery group and the laparoscopic group were 6 months (3-18 months) and 8 months (3-24 months), all of them were healthy. All the recipients received basiliximab for immunity induction before and after operation, and postoperative immunosuppression scheme was CNI+ metabolism drugs+ glucocorticoid. The renal function of 14 recipients all recovered in 2 weeks after transplantation, and all the recipients successfully get rid of dialysis after transplantation. As of August 2019, the 14 recipients were followed up for 3 to 12 months, during which the transplant kidney and the recipients were all normal.

Laparoscopy combined with Satinsky forceps technique is safe and feasible in the process of acquiring right-sided retroperitoneal laparoscopic living donor nephrectomy, which can prolong the donor vein to a large extent and reduce intraoperative blood loss.