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Table 3 – Technical details of various surgical techniques
Author
Surgical
technique
Open/LAP
Incision
Graft placement
(extraperitoneal
unless stated
otherwise)
Immunosuppression
Conventional kidney
transplantation
Nanni (2005)
[7]
,Oberholzer (2013)
[14] ,Modi (2013)
[13]
GIBI
Open
Roughly parallel to the inguinal ligament
Fossa iliaca
Steroids, cyclosporine or tacrolimus or sirolimus, and
MMF
Nanni (2005)
[7]
,Filocamo (2007)
[34]
,Malinka (2013)
[33]
,Kishore (2014)
[9]HSI
Open
Para-rectus incision prolonged medially to the
midline above the pubic symphysis
Fossa iliaca
Steroids, cyclosporine or tacrolimus or sirolimus, and
MMF
Minimally invasive
open kidney
transplantation
Øyen (2006)
[35]
MIKT
Open
7–9 cm transverse incision 3–5 cm above the
inguinal ligament, with the medial end 2–3 cm from
the midline
Fossa iliaca
Steroids, cyclosporine, and MMF
Filocamo (2007)
[34]
MLI
Open
Longitudinal infraumbilical incision
Fossa iliaca
Different between subgroups
Mun (2007)
[18]MIVAKT LAP assisted
7–8 cm linear incision from the line of the external
iliac vessels to that of the urinary bladder
Fossa iliaca
Steroids, cyclosporine or tacrolimus, and MMF
Park (2008)
[36]
MSI
Open
10 cm transverse incision 3–4 cm above the inguinal
ligament, with the medial end 2–3 cm from the
midline
Fossa iliaca
NR
Brockschmidt (2012)
[19] ,Brockschmidt (2014)
[20]MAKT
Open
7–9 cm transverse incision one finger breadth above
the inguinal ligament, with the medial end 2–3 cm
from the midline
Fossa iliaca
Steroids, tacrolimus, and MMF. Induction in elderly
grafts: thymoglobin
Kacar (2013)
[37]MIKT
Open
Incision starting 5 cm inferior to the umbilicus and
extending inferiorly 4–5 cm along the pararectal
line
Fossa iliaca
NR
Malinka (2013)
[33]
STI
Open
9 cm or less incision, two fingers’ breadth above the
inguinal ligament
Fossa iliaca
Steroids, cyclosporine A, MMF, and induction
basiliximab
Kishore (2014)
[9]MFI
Open
Transverse suprapubic incision 2–3 fingers breadth
above the pubic symphysis
Fossa iliaca
NR
Kim (2016)
[21]
MSI
Open
10 cm transverse incision 3–4 cm above the inguinal
ligament, with the medial end 2–3 cm from the
midline
Fossa iliaca
NR
Laparoscopic kidney
transplantation
Modi (2013)
[13]
LKT
LAP, 5 additional
ports
Horizontal suprapubic 5–6 cm incision
Fossa iliaca—covered
by peritoneal flap
Calcineurin inhibitor-based immunosuppression.
Induction: rabbit antithymocytic globulin
Modi (2015)
[22]
LKT
LAP, 5 additional
ports
3–4 cm incision of the posterior fornix of vagina Fossa iliaca—covered
by peritoneal flap
Steroids, tacrolimus, and MMF. Induction: rabbit
antithymocytic globulin and methyl prednisolone
[6_TD$DIFF]
Robotic-
assisted kidney
transplantation
Oberholzer (2013)
[14]RAKT
LAP, 4 additional
ports
Paraumbilical vertical 7 cm midline
Intra-abdominal
(right lower quadrant)
Steroids, tacrolimus, and MMF Induction: rabbit
antithymocytic globulin
Menon (2014)
[15]
RAKT
LAP, 4 additional
ports
Periumbilical 4–5 cm vertical incision
Fossa iliaca—covered
by peritoneal flap
NR
Tsai (2014)
[16]RAKT
LAP, 2 additional
ports
7–9 cm transverse incision 1 cm above the pubic
tubercle curving upward parallel to the inguinal
ligament
Fossa iliaca
Steroids, cyclosporine or tacrolimus, and MMF.
Induction: steroids
Sood (2015)
[17]
RAKT
LAP, 4 additional
ports
5–6 cm periumbilical vertical incision
Fossa iliaca—covered
by peritoneal flap
Steroids, tacrolimus, and MMF. Induction: rabbit
antithymocytic globulin or thymoglobulin
Tugcu (2016)
[30]
RAKT
LAP, 4 additional
ports
5–6 cm periumbilical vertical incision
Fossa iliaca—covered
by peritoneal flap
NR
NR = not reported; LAP = laparoscopic; MMF = mycophenolate mofetil; GIBI = Gibson incision; HSI = hockey-stick incision; MLI = midline incision; COKT = conventional open kidney transplantation; MIKT = minimally
invasive kidney transplantation; MIVAKT = minimally invasive video-assisted kidney transplantation; MSI = modified skin incision technique; MAKT = minimal-access kidney transplantation; MFI = modified Pfannenstiel
incision; LKT = laparoscopic kidney transplantation; RAKT = robotic-assisted kidney transplantation; STI = short transverse incision.
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