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New Surgical Procedure Removes Kidney Through Navel

Posted on: Thursday, 17 July 2008, 00:20 CDT

A new surgical procedure at the Cleveland Clinic allows doctors to remove a kidney through a single incision in the bellybutton, reducing recovery time and leaving almost no scarring.

“The actual incision point on me is so tiny I'm not getting any pain from it. I can't even see it," said Brad Kaster, 29, who donated a kidney to his father this week.

Kaster was the 10th donor to undergo the procedure at the Cleveland Clinic.

Dr. Inderbir S. Gill and colleagues at the research hospital said the new procedure could make kidney donations more palatable by sharply reducing recovery time.

The Organ Procurement and Transplantation Network says over 80,000 Americans are awaiting kidney transplants. Last year, there were about 13,300 kidney donors in the U.S., and about 45 percent were living donors.

The researchers said the first 10 recipients and donors whose transplants used the single-incision navel procedure have done well.

According to preliminary data from the first nine donors who had the bellybutton procedure showed they recovered in just under a month, while donors who underwent the standard laparoscopic procedure with four to six "key hole" incisions took just longer than three months to get back to normal.

The return to work time for single-point donors is about 17 days, versus 51 for traditional multi-incision laparoscopic procedure.

"For me, that's huge so I can get back to work," said Kaster, a self-employed optometrist.

Patients of the new procedure were on pain pills less than four days on average, compared with 26 days for laparoscopic patients.

"This represents an advance, for the field of surgery in general," said Gill, who predicted the bellybutton entry would be used increasingly for major abdominal surgery in a "nearly scar-free" way.

Gill said he believes this may very well decrease the disincentive to (kidney) donation.

Drs. Paul Curcillo and Stephanie King of Drexel University College of Medicine in Philadelphia developed a single-incision technique and Curcillo was the first to use the method to remove a woman's gallbladder through her bellybutton in May 2007. They've since used it for a number of different kinds of surgery.

“The bellybutton procedure will definitely make things better for the donor. A donor is one of the most altruistic people you'll ever meet. He's giving his kidney up. So anything you can do to make it better for that patient, they deserve it," said Curcillo.

For more than 15 years now, laparoscopic surgery has revolutionized the operating room, replacing long incisions with small cuts and vastly reducing pain and recovery time. Researchers are now exploring ways to eliminate scars by putting instruments through the body's natural openings like the mouth, nose and vagina to perform surgery.

The clinic's internal review board approved the procedure as an extension of its laparoscopic surgical work. Gill has begun training other surgeons on the procedure. It is not used to transplant the kidney into the receiving patient.

“The method needs to be studied to determine if patients fare better. The reality is that nobody knows if this is an advance other than cosmetic," said Dr. Louis R. Kavoussi, head of the Arthur Smith Institute for Urology of the North Shore Long Island Jewish Health System in New York and the co-author of an editorial in the journal

Scott Bolender, 39, of Washington Court House, was to receive a kidney Thursday from his niece, Chanda Calentine, by way of her bellybutton.

"I'm just looking forward to getting out of bed," said Bolender.

Bolender has been unable to work because of Wagner's disease, an autoimmune disease that attacks the kidneys. He has been undergoing lifesaving dialysis since 2005.

Calentine, 30, of New York City, said she was thrilled to provide a kidney for her good-natured uncle and that she expects to do fine with a single remaining kidney.

She also said she was confident in the promise of a "nearly scar-free" post-surgical bellybutton, but was prepared for the alternative.

"A week ago I got a one-piece (bathing suit)," she joked.

During the procedure, a three-quarter inch incision in the interior of the bellybutton and inserting a tube-like port with several round entry points for inserting a camera and other tools into the belly.

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On the Net:

• Cleveland Clinic
• Organ Procurement and Transplantation Network

Source: redOrbit Staff & Wire Reports

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