The patient is positioned in the lateral decubitus position. The kidney rest is fully raised and the table is flexed 20 degrees. A 7-8 centimeter midline infra-umbilical incision is made for a hand insertion device. Two subcostal 5-12 mm ports are placed for an endoscope and a working instrument, one just off the midline and one at the mid-clavicular line. The technique involves in order: colon mobilization, identification and mobilization of the ureter, anterior exposure of the kidney, isolation of the renal vein and dividing its branches, complete mobilization of the kidney, and isolation of the renal artery. To remove the kidney, the ureter is doubled clipped using 10 mm endoclips and divided. The artery and vein were stapled using a TA 30 endostapler and then divided and the kidney is then removed through the midline incision. Only three conversions to an open nephrectomy were required out of the first 400 laparoscopic donor nephrectomies performed at our institute. Dissecting the artery origin at the aorta and using TA instead of a GIA stapler will increase the length of the vessels. This is especially important when there is an early branching of the renal artery, as in this case, to achieve a single lumen.