Hopkins doctors remove donor kidney through patient's vagina

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Hopkins doctors remove donor kidney through patient's vagina

By Sara Michael
Examiner Staff Writer 2/3/09

Johns Hopkins doctors have performed what they believe is the first-ever surgery to remove a healthy donor kidney through a small incision in the back of the patient's vagina.

The patient had less pain and a shorter recovery time -- benefits that could encourage more kidney donations, doctors said.

"We are all about trying to reduce the disincentives to donation," said Dr. Robert Montgomery, chief of the transplant division at Johns Hopkins University School of Medicine, who lead the surgical team.

The surgery, performed Thursday, eliminated the need for a five- to six-inch incision in the abdomen of the patient, a 48-year-old woman from Lexington Park, Md., who donated her kidney to her niece.

Instead, the patient has only a few small scars on her abdomen.

Doctors made a smile-shaped incision in the back of her vagina and inserted an inflatable bag through a tube to hold the incision open. The kidney was then pulled out intact, Montgomery said.

"As far as we know, no one has ever applied this type of procedure to a donor kidney," he said.

Cancerous or nonfunctioning kidneys that were a hazard to the patient's health have been removed this way, but doctors don't have to worry about keeping the organ intact and free from trauma.

With a less painful procedure, patients may be more willing to donate a kidney, Montgomery said.

About 100,000 people are awaiting kidney transplants, according to the National Kidney Foundation.

"It's another step toward really reducing the impact of the operation on the donor," Montgomery said.

The kidney extraction is part of a growing trend of procedures that uses a natural body opening, such as mouth, vagina or anus, to remove organs or tissues.

These surgeries can be scarless and painless, and safer for obese patients, said pioneer Dr. Anthony Kalloo, director of gastroenterology at Hopkins' School of Medicine.

Kalloo started experimenting with these procedures in a lab setting in 1999, and the first of these procedures was done about five years ago.

The procedures last longer than traditional and laproscopic surgeries, which use tiny incisions and specialized instruments. But as the technique evolves, it will improve, Kalloo said.

"This is the next step."

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