In what is believed to be a first-ever procedure, surgeons at Johns Hopkins have successfully removed a healthy donor kidney through a small incision in the back of the donor's vagina.
"The kidney was successfully removed and transplanted into the donor's niece, and both patients are doing fine," says Robert Montgomery, M.D., Ph.D., chief of the transplant division at Johns Hopkins University School of Medicine who led the team that performed the historic operation.
The transvaginal donor kidney extraction, performed Jan. 29 on a 48-year-old woman from Lexington Park, Md., eliminated the need for a 5-to-6-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 nonfunctioning 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 United States 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, hospitalization and convalescence," says 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.
|Contact: Eric Vohr|
Johns Hopkins Medical Institutions