Hand-assisted laparoscopic nephrectomy in a high risk overweight donor with left-sided IVC, and previous abdominal surgery

Highlights • Surgical planning based on preoperative CTA is necessary in patients with vascular anomalies in order to avoid complications. • Intrabdominal adhesions are common in patients with previous abdominal surgery and can affect the surgical approach for donor nephrectomy. • Considering the extension of the donor eligibility criteria, it is expected to see cases with congenital vascular anomalies.
Introduction The extension of donor eligibility criteria represents one of the possible ways to increase the organ shortage, thus decreasing the waiting time for kidney transplantation. Expectedly, this strategy is associated with a growing number of more technically demanding living donor nephrectomy procedures requiring careful assessment, and sound surgical experience in order to avoid intraoperative complications. Case presentation After a thorough evaluation through preoperative imaging, we performed a hand-assisted left laparoscopic living donor nephrectomy in a 56 year-old overweight patient with history of prior abdominal surgery, harboring a left-sided inferior vena cava (IVC). Discussion/conclusion This case describes our comprehensive approach in this complex surgical scenario to preserve donor safety and provide an optimal kidney graft.