By IANS,
Washington : Surgeons at Johns Hopkins have successfully pulled out a healthy kidney through a small incision at the back of the donor’s vagina, in a historic first ever operation.
“The kidney was successfully removed and transplanted into the donor’s niece, and both patients are doing fine,” said Robert Montgomery, chief of the transplant division at Johns Hopkins University School of Medicine (JHUSM), who led the operation.
The transvaginal donor kidney extraction, performed on Jan 29 on a 48-year-old woman from Lexington Park, eliminated the need for a gaping five to six inch abdominal incision and left only three pea-size scars on her abdomen, one of which is hidden in her navel.
Transvaginal kidney removals have been done previously to remove cancerous or non-functioning kidneys that endanger a patient’s health, but not for healthy kidney donation.
“Because transplant donor nephrectomies are the most common kidney removal surgery – 6,000 a year just in the US – this approach could have a tremendous impact on people’s willingness to donate by offering more surgical options,” says Montgomery.
“Since the first laparoscopic donor nephrectomy was performed at Johns Hopkins in 1995, surgeons have been troubled by the need to make a relatively large incision in the patient’s abdomen after completing the nephrectomy to extract the donor kidney.
“That incision is thought to significantly add to the patient’s pain, hospitalisation and convalescence,” said Montgomery. “Removing the kidney through a natural opening should hasten the patient’s recovery and provide a better cosmetic result.”
Both laparoscopies and transvaginal operations are enabled by wandlike cameras and tools inserted through small incisions. In the transvaginal nephrectomy, two wandlike tools pass through small incisions in the abdomen and a third flexible tool housing a camera is placed in the navel.
Video images displayed on monitors guide surgeons’ movements. Once the kidney is cut from its attachments to the abdominal wall and arteries and veins are stapled shut, surgeons place the kidney in a plastic bag inserted through an incision in the vaginal wall and pull it out through the vaginal opening with a string attached to the bag.
Montgomery says the surgery took about three-and-a-half hours, roughly the same as a traditional laparoscopic procedure, said a JHUSM release.
The procedure is one of a family of new surgical procedures called natural orifice translumenal endoscopic surgeries (NOTES) that use a natural body opening to remove organs and tissue, according to Anthony Kalloo, director, division of gastroenterology at JHUSM and the pioneer of NOTES.
The most common openings used are the mouth, anus and vagina.