First keyhole kidney transplant performed by hospital
SURGEONS from St George’s Hospital performed a landmark operation on Wednesday 26 May to remove a kidney from a live donor using keyhole surgery.
The laparoscopic procedure, which was first developed fourteen years ago, makes St George’s only the fifth hospital in the country to offer the less invasive form of transplant surgery to kidney donors.
But by using a spin-off surgical technique that bypasses the bowel and other organs contained in the abdomen, St George’s is the first transplant centre in the UK to offer a new form of keyhole kidney extraction called the ‘extra-peritoneal approach’.
The procedure minimizes the damage that can be inflicted on other internal organs during a conventional laparoscopy.
The transplant, which comprised two carefully synchronized operations to remove a healthy kidney from a donor and implant the organ into a patient suffering from chronic kidney failure, took place in two adjacent operating theatres at the hospital. The procedure to extract the organ, which is called a nephrectomy, lasted two hours and was performed by Mr Jiri Fronek.
Senior transplant surgeon Mr Rene Chang said:
“The keyhole procedure we performed for the first time today [26 May] represents a significant milestone in the history of the hospital’s kidney transplant unit.
“The operation is less invasive than the traditional surgical method used to extract a kidney and should allow a donor to spend less time in hospital and recover more quickly from their operation.”
“The operations were successful and both the donor and the recipient are recovering well.”
The traditional method used to extract a kidney from a live donor involves the surgeon making a 9-inch cut below the ribcage.
But with keyhole extraction, three small incisions – each one measuring only half an inch in length – are made in the body through which a fibre-optic camera and surgical instruments are passed to excise the kidney from the surrounding tissue. The kidney is then removed through a small incision at the lower abdomen and passed to a second surgical team to insert into the recipient.
Although the keyhole procedure is more intricate than the conventional form of surgery and takes an extra thirty minutes to perform, the less invasive nature of the operation means that the openings created by the surgeon take less time to heal. As a result the donor’s stay in hospital is reduced from six to three days and the recovery period is shortened from three months to six weeks.
Mr Jiri Fronek commented about the procedure and said:
“Keyhole retrieval offers considerable benefits for donors, many of whom are starting to request this form of surgery.”
“We hope the improvements in recovery offered by this new form of surgery will lead to more people coming forward to donate an organ to patients afflicted with kidney problems. We expect to perform one procedure every two weeks this year and build up to one every week thereafter.”
Patients with chronic kidney failure are given dialysis to artificially remove waste products from the blood several times a week until a replacement kidney can be found.
However, a national shortage of organs and organ donors often means patients die from end stage kidney failure.
Figures from the UK Transplant Authority show that more than 5,000 patients across the country were waiting for a new kidney in May.
St George’s is a leading centre for kidney transplantation and last year celebrated its tenth anniversary.
Surgical teams at the hospital successfully transplanted 70 kidneys last year.