To investigate the best surgical method and systematic operation of retroperitoneal laparoscopic living donor nephrectomy.

Forty-five cases of living donors subject to nephrectomy by the new retroperitoneal laparoscopic technique from March 2011 to April 2015 were retrospectively analyzed. Procedure were as follows:(1)lateral position and select the puncture point A posterior axillary line and 2cm below costal arch(A), anterior posterior axillary line and 2cm below costal arch (B), 2 cm above iliac crest (C); (2)dissociate kidney and ureter; (3)dissociate the vessel of renal and cut off the vein of adrenal and reproductive, then cut off the ureter; (4)make an incision from groin, cut off the arteriovenous vessel of renal.

All operations were completed successfully, no one converted to open surgery. The mean operating time was (62±7) min, the mean warm ischemia time was (1.2±0.6) min. Living donor kidney artery length: (2.5±0.4) cm in left, (3.5±0.6) cm in right. Living donor kidney vein length: (3.6±0.4) cm in left, (1.7±0.2) cm in right. Blood loss was (45±4) ml. Hospital stay after operation was (4.5±1.5) d, the incision beauty satisfaction was good.

It is safe and effective of the new retroperitoneal laparoscopic living donor nephrectomy. Programmed operation of the anatomy is the best way to reduce the operation difficulty and complications, can increase the safety obviously and shorten the learning curve.