Introduction: Laparoscopic donor nephrectomy has been adopted as an acceptable technique with a quicker recovery and acceptable risks in experienced hands. Most centers, however, will only offer a laparoscopic approach provided that it is a left donor nephrectomy. This is mostly due to concerns regarding a shorter renal vein on the right side, theoretically increasing the risk of significant bleeding in the donor, as well as greater difficulty in transplanting a shorter renal vein. On the other hand, laparoscopic right donor nephrectomy (LRDN) offers several advantages. These include decreased operative time and avoidance of splenic injury. In addition, more donors have been shown to have proportionally better functioning left kidney; LRDN leaves these donors with the better functioning kidney.

Methods: At our center, we do not have any hesitation in performing LRDN, but rather determine the side based on simplicity of vascular anatomy and results of a nuclear medicine renal function scan, as well as other minor pathology such as benign cysts and dual collecting systems. If both sides are equivocal, the right side is preferred.

Results: The video shows briefly the concerns and advantages of LRDN. It then focuses on demonstrating the operative technique of this procedure.

Conclusion: In conclusion, we feel that LRDN is as safe as a left laparoscopic donor nephrectomy. We often find that a right donor nephrectomy is more appropriate than a left nephrectomy based on renal function and because of less operating time due to easier exposure.