"One of the most revolutionary elements about this procedure is the fact that it reduces the donor's recovery time and leaves no visible scars", stated Louis Kavoussi, MD, chairman of urology at the North Shore - Long Island Jewish Health System and head of the Arthur Smith Institute of Urology in Lake Success, New York, who was the surgeon who recently performed the donor nephrectomy or removal of the kidney. The actual incision was less than two inches wide. Once healed, the patient will not even see the scar.
In addition to Dr. Kavoussi, the transplant surgical included Lee Richstone, MD, chief of robotic and laparoscopic surgery at the Smith Institute, and Ernesto Molmenti, MD, director of transplant surgery at North Shore University Hospital.
This procedure came on the heels of a surgical milestone achieved by the Cleveland Clinic, where doctors removed a kidney through a single incision in a patient's bellybutton. Dr. Kavoussi took the process one step further, making this procedure the first of its kind in the world. Two days after the procedure, the patient was released from the hospital, with nary a scar to show.
Dr. Kavoussi and his team have also been performing donor nephrectomies through a single incision in the bellybutton. Decisions on whether to remove the kidney through the bellybutton or just above the pubic bone vary from patient to patient. The former procedure is not appropriate for patients who have had prior and/or major abdominal surgeries, or suffer from obesity.
The procedure involves making approximately a one or two-inch incision just above the pubic bone, in the interior of the bellybutton. A tube-like port is then inserted - one that contains several round entry points for inserting a camera and other tools into the belly.
The area is inflated with carbon dioxide to provide manoeuvering room. The kidney is then freed from connecting tissue, wrapped in a plastic bag and removed through the navel or through the incision above the public bone when the blood supply is cut, shrinking the organ's fist-like size. The incision is expanded to about 1,5 inches to extract the kidney after the port is removed.
North Shore University Hospital is the only hospital in the world to perform the surgery using this technique. This surgical milestone, according to Dr. Kavoussi, "really isn't about us. It's all about the patient. Donors are some of the most incredible and altruistic people that one meets. So, if we can do something to make it a little easier for the donors, why shouldn't we?"
Dr. Kavoussi was the first surgeon in the country to perform a laparoscopic donor nephrectomy when he was at John Hopkins Hospital in Baltimore, Maryland, in 1995.