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Hopkins Surgeons Remove Donor Kidney Through Vagina

Kathleen Blanchard's picture

Surgeons at Johns Hopkins University have removed a kidney from a donor for transplant. The vaginal removal of the kidney was performed using a minimally invasive procedure that surgeons say may increase the willingness of others to donate their kidney.

Robert Montgomery, M.D., Ph.D., chief of the transplant division at Johns Hopkins University School of Medicine led the kidney transplant team in performing one of the first surgeries ever to remove a kidney by way of the vagina.

The kidney from the donor was removed through a small incision in the back of the vagina from a 48-year-old female, on January 29.

The procedure, called a transvaginal kidney extraction, has been performed in the past to remove damaged and diseased kidneys, but never for kidney transplant, and never on a healthy kidney. The operation performed by the Hopkins transplant team eliminated the usual abdominal incision required for kidney donors.

Dr. Montgomery says, "Since the first laparoscopic donor nephrectomy [kidney removal] was performed at Johns Hopkins in 1995, surgeons have been troubled by the need to make a relatively large incision in the patient's abdomen after completing the nephrectomy to extract the donor kidney. That incision is thought to significantly add to the patient's pain, hospitalization and convalescence. Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result."

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The donor has a small incision hidden in her naval, a lot less pain, and a shorter recovery time. Dr. Montgomery believes the success using vaginal removal of a kidney for transplant might increase the willingness of others to donate a kidney.

A traditional procedure, known as laparoscopy, guided the vaginal kidney removal. The operation took approximately three and a half hours, just as a traditional laparoscopy.

The new type of procedures are called NOTES (natural orifice translumenal endoscopic surgeries), designed to used natural body orifices to remove organs and tissues. The most common body openings used are the mouth, anus and vagina, as was the case of the vaginal kidney donation. You may remember the news of physicians who removed an appendix through the mouth.

Minimally invasive surgeries are good news in terms of recovery. However, some surgeons believe more studies are needed to compare NOTES to traditional surgeries.

Anthony Kalloo, M.D., the director of the Division of Gastroenterology at Johns Hopkins University School of Medicine and the pioneer of NOTES, supports those studies. He says, "Natural orifice translumenal endoscopic surgery is the final frontier to explore in making surgery scarless, less painful and for obese patients, much safer. An organ donor, in particular, is most deserving of a scar-free, minimally invasive and pain-free procedure."

The groundbreaking vaginal removal of the donor's kidney has been a success. Dr. Montgomery reports, "The kidney was successfully removed and transplanted into the donor's niece, and both patients are doing fine."