UBC Reports | Vol. 46 | No. 15 | October 05, 2000

New procedure a cut above

Technique makes kidney donors' lives easier, say transplant surgeons

The surgical invasion associated with kidney donation will be sharply reduced thanks to a new procedure being launched in B.C. by two UBC transplant surgeons. "We hope to attract more donors with this less invasive technique," says Dr. Mark Meloche, an associate professor of Surgery.

"It should be easier for people to donate because the whole process is less taxing on the body and allows people to get back to their activities sooner," adds Meloche, who is head of Surgery for the British Columbia Transplant Society (BCTS).

When he and clinical associate professor of Surgery Dr. Mark Nigro bring the procedure to the UBC site of Vancouver Hospital and Health Sciences Centre (VHHSC) next year, it will be one of the first facilities in Canada to use the new transplant method.

Called minimally invasive surgery, the procedure uses a laparoscope -- a tube attached to a 10-millimetre-wide camera -- and tiny instruments inserted into small incisions to extract the kidney. Most donors are able to return to activities in about two weeks -- one-third to one-quarter the previous recovery time.

Nigro, a director of renal transplant surgery at VHHSCand head of Retrieval Services for BCTSreports that his first minimal access patient was able to leave hospital to play in a championship pool game 36 hours after surgery. The standard procedure for kidney removal, or nephrectomy, requires a 15-20 centimetre lateral incision in the flank that cuts through muscle. It requires about four to six days recovery in hospital and six to eight weeks at home. In the new procedure, the surgeon makes several vertical incisions about 10 millimetres in length above the navel without cutting into muscle.

The laparascope with its tiny camera is inserted and an image of the interior of the surgical site is shown on a high-resolution screen. Small instruments and stapling devices are inserted into the incisions and are operated remotely from outside the body.

The kidney is drawn out in an operation that takes about three to 3-1/2 hours, about one hour longer than the standard procedure.

The project will yield clinical, research and teaching benefits, says Nigro. He credits VHHSC for its support in providing equipment for the program.

Within the next six months, he and Meloche will be training residents in the technique which was developed in a Baltimore, Md. hospital about three years ago.