2074 A NOVEL BRIDGING HAND-ASSISTED LESS DONOR NEPHRECTOMY TECHNIQUE AND COMPARISON TO CONVENTIONAL HAND-ASSISTED LAPAROSCOPIC DONOR NEPHRECTOMY

INTRODUCTION AND OBJECTIVES: Recently, laparoendoscopic single-site surgery (LESS) has been employed to decrease the morbidity of kidney donation. Concerns have been raised about the increased surgical complexity, learning curve, and warm ischemia times. In an attempt to circumvent the complexity of LESS, we have developed a bridging hand-assisted-LESS (BLESS) technique that allows the surgeon to gain experience with single incision surgical techniques in the setting of traditional hand-assisted laparoscopy. The purpose of this study is to present the BLESS technique and to compare the outcomes of this technique with conventional hand-assisted laparoscopic donor nephrectomy (HALDN). METHOD(S): Similar to LESS, the BLESS technique employs a single periumbilical incision. Enlargement of the fascial incision to 7 cm facilitates placement of a Gelport device and allows some triangulation of the three ports inserted through the hand-assist device. Parts or all of the case may be performed with single incision techniques. At the surgeon's discretion, placement of a single additional 5 mm port allows the surgeon to convert to a hand-assisted technique with additional ports placed through the Gelport to perform the dissection. A retrospective comparison of five BLESS donors to 20 consecutive HALDN patients performed by the same surgeon was performed. Preoperative, perioperative and postoperative variables were compared. RESULT(S): Compared to HALDN patients, BLESS patients had similar preoperative characteristics including age (p=0.881), sex (p=0.858) and preoperative creatinine (p=0.790), but had lower BMI (21.6 vs. 26.3; p=