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NOTES Techniques Minimize Scars For Living Kidney Donors

Wed, 08/10/2011 - 6:24am

Kidney transplant from a living donor presents the best option and results in increased organ survival. This has lead to new surgical technologies for the improvement of transplantation procedures.

The work presented today at IDIBAPS - Hospital Clínic of Barcelona by Dr. Antonio Alcaraz, IDIBAPS investigator and head of the department of Urology, and his team, confirm the feasibility of surgical techniques with minimal scars for the extraction of a kidney. The team led by Dr. Alcaraz applies the modified transvaginal (through the vagina) and transumbilical (through the navel) extraction techniques to kidney transplantation.

The medical team at Hospital Clínic is formed by Dr. Alcaraz, Dr. M. José Ribal, head of the Uro-Oncology Unit, Dr. Joan Beltran, head of the anesthesia section, Dr. Mireia Musquera, responsible for the Kidney Transplant Surgical Unit, and nurse Marta Tomás. The team has operated on four males by the technique called LESS (Laparoscopic-Endoscopic Single-Site Surgery), also known as single port transumbilical surgery. The application of the technique in women (transvaginal nephrectomy) involves two pathways (vagina and abdomen), and two minimal scars (abdomen) of 5 and 10 millimeters.

In the case of men (single-port nephrectomy), the pathway is restricted to the navel (which is a scar with a very little vascularization). "The minimally invasive surgical techniques for removal of living donor kidneys have many advantages: better quality of life for the donor, minimal scarring, shorter hospital stay and less pain", says Dr. Alcaraz. "The surgical technique is completely reproducible and can be considered a good alternative procedure that could increase the rate of living donors among women."

This same team performed the first European transvaginal nephrectomy applied to the treatment of a kidney cancer in 2007. This minimally invasive technique made possible the removal of the affected kidney with only two 1 cm incisions in the abdomen, and another hidden inside the vagina. Since then, Dr. Alcaraz and his team have performed many kidney withdrawals through the vagina, a pathway that is presented today as a 100 percent safe and effective alternative for living donor transplants.

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