For referring physicians
Single-port retroperitoneal living donor nephrectomy
The donor operation I do with NYU Langone transplant surgery: one incision, the retroperitoneum, the patient supine, and the right kidney when the right kidney is the one to take. What the approach changes and what it does not.
Why the retroperitoneum, and why the right
The standard laparoscopic donor nephrectomy goes through the abdomen and takes the left kidney, because the right renal vein is short and the liver is in the way. Supine anterior retroperitoneal access, the same access I use for the ureter, puts the SP robot straight onto the renal hilum without entering the peritoneum, with the renal artery and vein in direct view. The approach permits procurement from either side, so the side is decided by the donor's anatomy rather than by the technique.
Staying out of the abdomen means no bowel is handled. In the first six right-sided donors, the donors went home the same day, against about 48 hours after the laparoscopic operation, which is the finding we presented at the AUA in 2025. The adrenal is preserved. Every donor who was selected for a right nephrectomy during the series had the operation this way, without conversion.
Who does it
Jeffrey Stern and Bruce Gelb of NYU Langone transplant surgery operate with me, and Stern and I also do the renal autotransplants. The transplant ureter when it strictures is on the transplant ureter page.
The series
The single-center series of right-sided SP donor nephrectomies is written and in review, and a two-center retroperitoneal series is being assembled. Until they publish, the technique is documented in the videos, in the 3D donor atlas, and in the NYU Langone Physician Focus report from August 2025. The rest of the single-port work is at publications.leezhaomd.org.
Videos by operation
Most operative videos are age-restricted on YouTube, so you need to be signed in to watch them.