Methodist surgeons study transvaginal removal of donor kidney

Surgeons at The Methodist Hospital in Houston are studying a new way to make kidney donation safer, less invasive and almost scar free for women by using a new technique that removes kidneys transvaginally.

If surgeons first prove that this new technique is safe for the organ recipient, they will use it to remove the kidney from the donor, making recovery much easier. The technique is a new type of surgery called natural orifice translumenal endoscopic surgery (NOTES), in which surgeons use a natural opening in the body to minimize pain and scarring. According to the United Network for Organ Sharing (UNOS), more than 60 percent of living kidney donors are female.

"Our current technique of laparoscopic, minimally invasive kidney removal reduces side effects caused by open surgery," said Dr. Brian Dunkin, surgeon at The Methodist Hospital and and lead researcher on the study. "However, even with a minimally invasive technique, the incision is large enough to cause the pain, hernias and wound infections seen with open surgery."

Currently, kidney donors undergo a laparoscopic operation during which the surgeon prepares the kidney for removal by working through three ¼-inch incisions. However, when it comes time to remove the kidney, a larger three- to four-inch incision must be made for the extraction.

The larger incision is the source for most of the pain and scarring. Removing the kidney transvaginally - where there are relatively few pain fibers - could result in a nearly painless operation with no extraction scar, said Dunkin, who is also medical director of MITIE(SM), the Methodist Institute for Technology, Innovation and Education at Methodist.

There is a severe shortage of donated organs in the United States, creating more of a need for living donors. When a person decides to donate a kidney to a friend or loved one, he or she takes on risk of infection, pain and hernia, or weakness in the wall of a muscle that holds an organ in place, as a result of the surgery.

Using a NOTES technique, surgeons can perform increasingly complex procedures through natural body orifices such as the mouth, rectum or vagina, to reduce or eliminate those risks. Physicians at Methodist are studying transvaginal removal of the donor kidney and the safety of this technique for the donor and the recipient of the kidney.