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Open Access Study protocol

Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial

Leonienke FC Dols1*, Niels FM Kok1, Turkan Terkivatan1, TC Khe Tran1, Frank CH d'Ancona2, Johan F Langenhuijsen2, Ingrid RAM zur borg3, Ian PJ Alwayn4, Mark P Hendriks5, Ine M Dooper6, Willem Weimar7 and Jan NM IJzermans1

Author Affiliations

1 Department of Surgery, Erasmus MC, Rotterdam, the Netherlands

2 Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

3 Department of Anaesthesia, Erasmus MC, Rotterdam, the Netherlands

4 Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada

5 Department of Anaesthesia, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

6 Department of Nephrology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

7 Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands

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BMC Surgery 2010, 10:11  doi:10.1186/1471-2482-10-11

Published: 25 March 2010

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