{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:02:34Z","timestamp":1785315754360,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Native nephrectomy is frequently required in autosomal-dominant polycystic kidney disease (ADPKD) before or during transplantation, but the optimal minimally invasive approach is unsettled, and it is unclear whether the pattern of post-operative complications tracks with operative technique. We report a retrospective single-centre experience of hand-assisted laparoscopic (HAL) native nephrectomy and, alongside it, a technique-stratified scoping review of complications. Methods: We retrospectively reviewed all consecutive adults undergoing HAL native nephrectomy\u2014with an infra-umbilical midline hand-port and free intraperitoneal cyst rupture\u2014in preparation for transplantation in the period between December 2019 and December 2025. In parallel, we performed a PRISMA-ScR-compliant scoping review (MEDLINE, Embase, Scopus) of minimally invasive ADPKD nephrectomy, with duplicate independent screening and extraction, stratifying complications by operative approach and cyst-decompression method. No quantitative pooling was undertaken. Results: Twenty-three patients (mean age 52.8 \u00b1 9.9 years; 87% dialysis-dependent; 78% for transplant preparation) were included. Median operative time was 102 min (IQR 90\u2013122) with minimal blood loss, one transfusion (4%), and no open conversion. Complications occurred in 8\/23 (35%) and were bowel-predominant: one small-bowel perforation, two obstructions, and one ileus\u2014three of Clavien\u2013Dindo grade IIIb, all in right-sided nephrectomies and independent of specimen weight. Peri-operative mortality was 1\/23 (4%), from a non-technique-related mycotic aortic dissection. Of 481 records screened, 19 studies met inclusion; the cyst-decompression method was reported in only 7 (37%). Bowel events clustered in series using free intraperitoneal cyst rupture or puncture and were largely absent where decompression was contained, a pattern crossing platform boundaries and that is mechanistically consistent with intraperitoneal spillage of cyst contents. Conclusions: HAL native nephrectomy is a rapid and feasible means of removing massively enlarged polycystic kidneys before transplantation but, in our experience, carries a bowel-predominant morbidity that clustered in right-sided procedures and was independent of specimen weight. The sparse literature is consistent with\u2014but cannot confirm\u2014a relationship to intraperitoneal cyst spillage rather than to the hand-assisted approach itself. Whether contained cyst decompression can preserve operative efficiency while reducing bowel morbidity is a hypothesis warranting prospective study.<\/jats:p>","DOI":"10.3390\/jcm15155856","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:47:41Z","timestamp":1785145661000},"page":"5856","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hand-Assisted Laparoscopic Native Nephrectomy for Polycystic Kidney Disease Before Transplantation: A Single-Centre Case Series with a Technique-Stratified Focused Scoping Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9754-5028","authenticated-orcid":false,"given":"Fahim","family":"Kanani","sequence":"first","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaya","family":"Shwaartz","sequence":"additional","affiliation":[{"name":"Department of Transplantation and HPB Surgery, Toronto General Hospital, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirit","family":"Meller","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5374-0376","authenticated-orcid":false,"given":"Rotem","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Baytner Zamir Yosilevsky","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-7921","authenticated-orcid":false,"given":"Vladimir","family":"Tennak","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0172-3844","authenticated-orcid":false,"given":"Ashraf","family":"Imam","sequence":"additional","affiliation":[{"name":"Organ Transplantation Unit, Department of Surgery, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel"},{"name":"Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4878-8189","authenticated-orcid":false,"given":"Abed","family":"Khalaileh","sequence":"additional","affiliation":[{"name":"Organ Transplantation Unit, Department of Surgery, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel"},{"name":"Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviad","family":"Gravetz","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eviatar","family":"Nesher","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Beilinson Medical Centre, Petah Tikva 4941492, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/S0140-6736(18)32782-X","article-title":"Autosomal dominant polycystic kidney disease","volume":"393","author":"Alam","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1016\/S0140-6736(07)60601-1","article-title":"Autosomal dominant polycystic kidney disease","volume":"369","author":"Torres","year":"2007","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1038\/s41572-018-0047-y","article-title":"Polycystic kidney disease","volume":"4","author":"Bergmann","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1146\/annurev.med.60.101707.125712","article-title":"Polycystic kidney disease","volume":"60","author":"Harris","year":"2009","journal-title":"Annu. Rev. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1056\/NEJM199307293290508","article-title":"Autosomal dominant polycystic kidney disease","volume":"329","author":"Gabow","year":"1993","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1056\/NEJMra022161","article-title":"Polycystic kidney disease","volume":"350","author":"Wilson","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"iv15","DOI":"10.1093\/ndt\/gfu017","article-title":"Renal replacement therapy for autosomal dominant polycystic kidney disease (ADPKD) in Europe","volume":"29","author":"Spithoven","year":"2014","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"468","DOI":"10.5527\/wjn.v4.i4.468","article-title":"Current management of autosomal dominant polycystic kidney disease","volume":"4","author":"Akoh","year":"2015","journal-title":"World J. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1097\/01.ju.0000181208.06507.aa","article-title":"End-stage polycystic kidney disease: Indications and timing of native nephrectomy relative to kidney transplantation","volume":"174","author":"Fuller","year":"2005","journal-title":"J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.purol.2016.08.010","article-title":"Polycystic kidney disease and kidney transplantation","volume":"26","author":"Tillou","year":"2016","journal-title":"Prog. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1093\/ndt\/gfaf019","article-title":"Nephrectomy in autosomal dominant polycystic kidney disease: A consensus statement of the ERA Genes & Kidney Working Group","volume":"40","author":"Geertsema","year":"2025","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1111\/ans.18038","article-title":"Utilizing the same incision for staged renal transplant in patients with polycystic kidney disease requiring hand-assisted laparoscopic nephrectomy","volume":"92","author":"Huynh","year":"2022","journal-title":"ANZ J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00423-022-02737-9","article-title":"Introduction of laparoscopic nephrectomy for autosomal dominant polycystic kidney disease as the standard procedure","volume":"408","author":"Thomas","year":"2023","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2020.00107","DOI":"10.4293\/JSLS.2020.00107","article-title":"Laparoscopic nephrectomy for massive kidneys in polycystic kidney disease","volume":"25","author":"Collini","year":"2021","journal-title":"JSLS"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.urology.2020.06.090","article-title":"Simultaneous Hand-assisted Laparoscopic Bilateral Native Nephrectomy and Kidney Transplantation for Patients With Large Polycystic Kidneys","volume":"146","author":"Abrol","year":"2020","journal-title":"Urology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1111\/ajt.16310","article-title":"Simultaneous bilateral laparoscopic nephrectomy with kidney transplantation in patients with ESRD due to ADPKD: A single-center experience","volume":"21","author":"Abrol","year":"2021","journal-title":"Am. J. Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_19","unstructured":"(2026, May 15). OCEBM Levels of Evidence Working Group. The Oxford 2011 Levels of Evidence. Oxford Centre for Evidence-Based Medicine. Available online: https:\/\/www.cebm.ox.ac.uk\/resources\/levels-of-evidence."},{"key":"ref_20","first-page":"2127","article-title":"Methodological quality of case series studies: An introduction to the JBI critical appraisal tool","volume":"18","author":"Munn","year":"2020","journal-title":"JBI Evid. Synth."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Shweiki, A., Khalayleh, H., Rivin, M., Shabaneh, S., Khalaileh, A., and Imam, A. (2025). Minimally invasive nephrectomy for the management of polycystic kidney disease: The hilum-first technique. J. Clin. Med., 14.","DOI":"10.3390\/jcm14217485"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.urology.2020.05.069","article-title":"Robot-assisted synchronous bilateral nephrectomy for autosomal dominant polycystic kidney disease: A stepwise description of technique","volume":"153","author":"Gurung","year":"2021","journal-title":"Urology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s00345-025-05556-x","article-title":"Surgical outcomes of robotic bilateral nephrectomy compared to open surgery in adult polycystic kidney disease","volume":"43","author":"Castaneda","year":"2025","journal-title":"World J. Urol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1111\/ans.70192","article-title":"Autosomal Dominant Polycystic Kidney Disease Patients Requiring Nephrectomy: Characteristics and Surgical Considerations","volume":"95","author":"Chan","year":"2025","journal-title":"ANZ J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1002\/bco2.263","article-title":"Robotic bilateral nephrectomy for large polycystic kidney disease","volume":"4","author":"Masterson","year":"2023","journal-title":"BJUI Compass"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jss.2025.12.015","article-title":"Robotic-assisted simultaneous bilateral native nephrectomy and living donor kidney transplantation","volume":"318","author":"Vianna","year":"2026","journal-title":"J. Surg. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1016\/j.transproceed.2022.03.061","article-title":"Simultaneous robotic-assisted bilateral native nephrectomy and kidney transplantation for ADPKD in recipients with high body mass index: Report of 2 cases","volume":"54","author":"Spaggiari","year":"2022","journal-title":"Transplant. Proc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/iju.14906","article-title":"Hand-assisted laparoscopic bilateral native nephrectomy for autosomal dominant polycystic kidney disease","volume":"29","author":"Chalklin","year":"2022","journal-title":"Int. J. Urol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"rjae274","DOI":"10.1093\/jscr\/rjae274","article-title":"Semi-simultaneous hand-assisted laparoscopic bilateral nephrectomy and kidney transplantation from the same incision in ADPKD: First case report in Saudi Arabia","volume":"2024","author":"Shaheen","year":"2024","journal-title":"J. Surg. Case Rep."},{"key":"ref_30","first-page":"1113","article-title":"Simultaneous laparoscopic bilateral nephrectomy in polycystic kidney disease using same trochars placed in the midline","volume":"46","author":"Penbegul","year":"2020","journal-title":"Int. Braz. J. Urol."},{"key":"ref_31","first-page":"111405","article-title":"Minimally invasive management of horseshoe kidney with polycystic kidney disease: A case report","volume":"132","year":"2025","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s11255-024-04234-y","article-title":"Native nephrectomy in patients with autosomal dominant polycystic kidney disease in kidney transplant program: Long-term single-center experience","volume":"57","author":"Navratil","year":"2025","journal-title":"Int. Urol. Nephrol."},{"key":"ref_33","first-page":"74","article-title":"Comparison between retroperitoneal laparoscopic nephrectomy and traditional open nephrectomy to treat polycystic kidney disease before kidney transplantation","volume":"21","author":"Lyu","year":"2024","journal-title":"Urol. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"6187","DOI":"10.12998\/wjcc.v12.i28.6187","article-title":"Incidental renal cell carcinoma post bilateral nephrectomy in autosomal dominant polycystic kidney disease","volume":"12","author":"Shin","year":"2024","journal-title":"World J. Clin. Cases"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5856\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:38:29Z","timestamp":1785314309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/15\/5856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":34,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15155856"],"URL":"https:\/\/doi.org\/10.3390\/jcm15155856","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]}}}