Laparoscopic vs. Open Nephrectomy

[Onegativedonor]

Hey I just have a question about laparoscopic vs. open nephrectomys. I'll try to condense this to the essential details to keep from boring people.

I'm pursuing non-directed donation as an O- donor. I was previously evaluated at the Cleveland Clinic but I'm now thinking about pursuing the donation through a hospital near my hometown, which is 5+ hours from Cleveland.

The CC offers the laparoscopic procedure while my hometown hospital does the open nephrectomy. I know the laparoscopic procedure is less invasive, leaves a smaller scar, and has quicker recovery times. I don't care about scarring, but recovery time is decently important to me.

Also, this may sound stupid, but I'm most nervous about being on a catheter. As crazy as it sounds, I'm more nervous about that than handing over a kidney. How much longer would I be on the catheter for the open surgery?

[Onegativedonor]

I felt like I should explain: the reason I'm thinking about switching from the Cleveland Clinic is because it would be hassle to have my support person stay with me in Cleveland for a week. Then he would have to drive me back for the checkup a week after that, and then follow-up appointment a week after that. And then it would be an 11 hour round trip for my checkups at the 1 month, 6 months, 1 year etc.

On the other hand, they are one of the best in the world, their Donor Win program is awesome, and I already feel like I have a bond/trust with the nephrologist and prospective surgeon.

[Michaelynn in reply to Onegativedonor]

I think it would be worth the drive.

Especially if you have a higher level of confidence. I find supportive people are really not as inconvenienced as you think. They get a boost out of helping you and bring involved with the miracle. They really don’t mind.

[Michaelynn]

Hello

I donated in 2015 by laparoscopy. I am a nurse and given a choice, I would go laparoscopy all the way. Open surgery recovery seems brutal in my opinion. Cutting through muscles facia etc to get to the kidney spells painful recovery. You are also more exposed to infection risk and moving post op would be more Painful.

Laparoscopy is so much more gentle.

I think the recovery time for open procedure would be longer and more intense.

In either case you only have a catheter for a short amount of time post op, and that’s going to be the least of your worries. My biggest post op problem was constipation!

[MrsCardosi]

I am not a doctor, nor do I play one on tv, but I did do an altruistic donation like you are considering. The difference is night and day. I'm shocked anyone is still doing open unless there is an emergency. It's like going to the dentist in 1950 compared to now. With my laparoscopic donation I was off the catheter within hours of the surgery. I don't remember them taking it out so it must have been pretty quick after. The recovery was quick and smooth. It is painful, I will not lie but I can only imagine it's worse with the open dealing with the larger incisions. It is also less risky. And if you are thinking about doing it in the next few months, CC is tops in the nation for infection control for both you and the recipient.

[MrsCardosi in reply to MrsCardosi]

Also like you said in your reply, the connection with the team is HUGE. I had three choices of hospitals here in PHX, and the team at St Joe's was hands down the best. I also could have chosen Mayo or Banner. Quality of the rest of your life, trumps the drive in my opinion. Like my team even called me with the pandemic hit about how to best protect myself - because it attacks kidneys. If you are considering meeting your recipient at a later time, mine is now one of my closest friends. We never in a million years would have found each other any other way because on the surface we appear so different.