Introduction

Laparoscopic living donor nephrectomy is now widely regarded as the standard surgical approach for living kidney donation in most centers due to its minimally invasive nature, reduced postoperative pain, shorter hospital stays, and improved cosmetic outcomes [1-4]. This approach encompasses a spectrum of minimally invasive techniques, including pure or hand-assisted transperitoneal laparoscopy, pure or hand-assisted retroperitoneal laparoscopy, laparo-endoscopic single-site surgery (LESS), embryonic natural orifice transluminal endoscopic surgery-assisted (E-NOTES), and robotic-assisted transperitoneal or retroperitoneal approaches [5-7].

The development and refinement of minimally invasive techniques are critical to enhancing donor safety and encouraging more individuals to donate by reducing the risks and discomfort associated with the procedure. Retroperitoneoscopic donor nephrectomy (RDN) was initially described by Yang et al. in 1995. In 2000, retroperitoneoscopic live donor nephrectomy for autotransplantation and allotransplantation was described. Retroperitoneoscopic approaches have the advantage of keeping the peritoneum intact and reducing the risk of visceral organ injuries when compared with transperitoneal approaches [8-10]. Despite its relatively limited adoption compared with the transperitoneal approach, retroperitoneoscopic living donor nephrectomy is a safe, feasible, and valuable minimally invasive option. In this study, we describe our institutional experience involving seven cases of retroperitoneoscopic living donor nephrectomy, which, to the best of our knowledge, represents the first reported case series of this procedure from the sub-Himalayan region of India.