Objective  To summarize the experience in retroperitoneal living donor nephrectomy under 3D laparoscopy and to investigate its clinical effect and safety.

  Methods  The clinical data of 19 cases who underwent retroperitoneal living donor nephrectomy under 3D laparoscopy were collected. Operation duration, intraoperative blood loss, renal warm ischemia time, length of renal artery, renal vein and ureter, incision size and operative complications were recorded. Postoperative renal function of donors and recipients was observed.

  Results  Nineteen cases of living donor nephrectomy were successfully completed under the 3D laparoscopy, and there were no conversion into conventional laparoscopy and open surgery. The operation duration of living donor nephrectomy under 3D laparoscopy was 80.5-125.2 (with an average of 102.3) min; intraoperative blood loss was 40.6-90.4 (60.8) ml; renal warm ischemia time was 100-230 (161) s. Length of renal artery, renal vein and ureter was 2.6-3.2 (2.9) cm, 2.2-3.0 (2.6) cm and 8-13 (10) cm, respectively. The incision size was about 5-6 cm, and the wound healed. Urine volume of the donors at 24 h after operation was 2 000-2 500 ml. Serum creatinine increased slightly in 1 case at 3 d after operation, and returned to normal through reexamination after 7 d and 1 month. The donors stayed in the hospital 5-7 (6) d after operation. All transplant operations were performed successfully, and delayed graft function did not occurred.

  Conclusion  Accuracy of operation can be improved effectively by 3D laparoscopic surgery system. It is safe and feasible to perform retroperitoneal living donor nephrectomy under 3D laparoscopy.