KANSAS CITY, Mo. – Surgeons at Saint Luke's Hospital are successfully removing healthy donor kidneys through a small incision in the back of the donor's vagina. The novel transvaginal kidney extraction procedure has the potential to increase living kidney donations by impacting people's willingness to donate.
Minimally invasive surgeon B. Todd Moore, M.D., performed what is believed to be the first transvaginal donor kidney extraction in the Kansas City area on Sept. 24, 2009. The donor patient was discharged home from the hospital the next morning.
All live donor kidney extractions at Saint Luke's Hospital are typically performed laparoscopically. With the transvaginal extraction technique, instead of removing the kidney through a 3- to 4-inch abdominal incision, the kidney is placed in a bag and removed vaginally much in the same way as vaginal hysterectomy. The patient is left with only four tiny scars on her abdomen, much like a routine outpatient gallbladder surgery.
Technically a more complex procedure, operative time is similar to the traditional kidney removal.
Transvaginal operations are enabled by a high definition camera placed through the navel and wand-like tools inserted through tiny incisions in the abdomen. The surgeon's movements are guided by images displayed on video cameras.
We've seen a dramatic difference in recovery and hospital stay for the donors,” said Dr. Moore.
“Typical laparoscopic donor kidney patients required up to four days of hospital recovery. This quicker return to normal activity could motivate many more people to participate in live kidney donation.”
Dr. Moore is director of Saint Luke's center for Advanced Minimally Invasive Surgery. Transvaginal extraction uses concepts similar to a newer investigational surgical technique called Natural Orifice Transluminal Endoscopic Surgery (NOTES) which uses a natural body opening such as the mouth, anus, and vagina to remove organs and tissue. These techniques limit incisions which in turn shortens recovery time and postoperative pain. Saint Luke's center is one of the few training sites for single incision procedures for other surgeons from across the country. The program also participates in several industry trials to advance the access devices and instrumentation used in minimally invasive procedures.
“This is an exciting developing option for donors in the kidney transplant program at Saint Luke's,” commented Dr. Moore. “There are only a handful of centers in the country performing this technique and we're again proud to be on the forefront.