Implementation of a pediatric kidney transplantation program in Uzbekistan: Feasibility and early outcomes

Figure 1 Positioning and port placement for hand-assisted laparoscopic donor nephrectomy. The patient is placed in a modified lateral decubitus position with flexion at the level of the iliac crest to increase the working space between the costal margin and the iliac spine. The upper arm is supported with an armrest, and all extremities are padded and secured. The hand-assist port is placed via a periumbilical incision. Additional laparoscopic ports are positioned under direct vision: One working port in the upper quadrant, and another in the lower quadrant for the camera. This setup allows optimal access for kidney mobilization, vascular dissection, and safe extraction through the hand-assist site.