Cleveland Clinic First To Perform Successful Live Kidney Donation Through Single Belly Button Incision |
Urologists Develop Scar-less Kidney Removal, New Procedure Holds the Potential to Increase Living Donations for Recipients in Need |
7/17/08 -- Family, friends and even altruistic strangers willing to donate a kidney now have a less invasive surgical option, called single-port trans-umbilical live donor nephrectomy. |
The procedure, which entails removing a kidney
via the belly button, has resulted in excellent kidney function in the
recipient, according to Cleveland Clinic surgeons who will publish their
findings in the August issue of the Journal of Urology. The new minimally
invasive surgical alternative could benefit many of the more than 75,000
patients currently in need of a kidney in the United States. “We’re truly taking minimally invasive surgery
to a new level with this procedure, and I can’t think of a more important use of
this advancement than performing scar-free kidney removal in a healthy donor,”
said Inderbir S. Gill, M.D., Chairman of Urology at Cleveland Clinic. “Kidney
donors are truly giving the gift of life, so if we can make their surgery less
daunting and less of an inconvenience while still maintaining the highest levels
of safety and the best outcomes in the recipient, we’re hopeful this will result
in more people stepping forward to donate.” |
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In this new approach being performed only at
Cleveland Clinic by Dr. Gill and his team, all aspects of kidney harvesting
are performed through the navel, including removal. Initial steps include
making a two-centimeter incision in the interior of the belly button,
inserting a single port into the incision with multiple channels that will
accommodate all surgical tools and the laparoscope, then inflating the abdomen
with carbon dioxide to provide more room to work. Once the kidney is freed, a
pliable plastic bag is wrapped around the organ, its blood supply is
disconnected, and the kidney is removed through the navel. “It is essential for a living kidney donation
to be successful and safe because, unlike other surgeries that affect only one
patient, there are two lives at stake during live transplantation. The kidney
has to be delicately removed to work perfectly in the recipient, so we have
zero tolerance for errors,” said Dr. Gill, who has been one of the pioneers of
laparoscopic urological surgery for the past decade. “We’re continuing to
document the outcomes of our single-port patients, but the initial reports and
feedback are promising.” In fact, initial data on the first nine cases
performed by Dr. Gill and his team suggest the following outcomes reports in
patients receiving single-port surgery versus traditional laparoscopic surgery
for live donor nephrectomy:
Laparoscopic
Patients Single-Port Patients Dr. Gill is quick to note that these are
initial data and that kidney donation through the belly button is not
available to all patients. Donors may not be eligible if they have had
multiple major abdominal surgeries or are morbidly obese, as both conditions
limit visibility and movement inside the abdomen. Other members of the team
include Drs. Monish Aron, David Canes, David Goldfarb, Mihir Desai, Jihad
Kaouk, Stuart Flechner, and Venkatesh Krishnamurthy. The Glickman Urological and Kidney Institute
is one of 26 institutes at Cleveland Clinic that group multiple specialties
together to provide collaborative, patient-centered care. The institute is a
world leader in treating complex urologic and kidney conditions in adults and
children, and U.S.News & World Report has ranked the urology program
among the top two in the nation for nine consecutive years. Cleveland Clinic, located in Cleveland, Ohio,
is a not-for-profit multispecialty academic medical center that integrates
clinical and hospital care with research and education. Cleveland Clinic was
founded in 1921 by four renowned physicians with a vision of providing
outstanding patient care based upon the principles of cooperation, compassion
and innovation. U.S.News & World Report consistently names Cleveland
Clinic as one of the nation’s best hospitals in its annual “America’s Best
Hospitals” survey. |
| Source: http://www.clevelandclinic.org/ |
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