Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial
- PMID: 20338030
- PMCID: PMC2856541
- DOI: 10.1186/1471-2482-10-11
Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial
Abstract
Background: Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee the donor's safety, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy experienced by the donor. However, this method is characterised by higher in hospital costs, longer operating times and it requires a well-trained surgeon. The hand-assisted retroperitoneoscopic technique may be an alternative to a complete laparoscopic, transperitoneal approach. The peritoneum remains intact and the risk of visceral injuries is reduced. Hand-assistance results in a faster procedure and a significantly reduced operating time. The feasibility of this method has been demonstrated recently, but as to date there are no data available advocating the use of one technique above the other.
Methods/design: The HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs.
Discussion: This study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy.
Trial registration: Dutch Trial Register NTR1433.
References
-
- United Network for Organ Sharing. http://www.unos.org
-
- Kok NF, Lind MY, Hansson BM, Pilzecker D, Mertens zur Borg IR, Knipscheer BC, Hazebroek EJ, Dooper IM, Weimar W, Hop WC. Comparison of laparoscopic and mini incision open donor nephrectomy: single blind, randomised controlled clinical trial. BMJ. 2006;333(7561):221. doi: 10.1136/bmj.38886.618947.7C. - DOI - PMC - PubMed
-
- Dols LF, Kok NF, Terkivatan T, Tran KT, Alwayn IP, Weimar W, Ijzermans JN. Optimizing left-sided live kidney donation: hand-assisted retroperitoneoscopic as alternative to standard laparoscopic donor nephrectomy. Transpl Int. 2009. in press . - PubMed
-
- Sundqvist P, Feuk U, Haggman M, Persson AE, Stridsberg M, Wadstrom J. Hand-assisted retroperitoneoscopic live donor nephrectomy in comparison to open and laparoscopic procedures: a prospective study on donor morbidity and kidney function. Transplantation. 2004;78(1):147–153. doi: 10.1097/01.TP.0000133280.74695.34. - DOI - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
