UNUSUAL KIDNEY TRANSPLANT: Doctors remove a kidney through the vagina
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Surgeons at The Johns Hopkins Hospital in Baltimore last month successfully removed a donor's healthy kidney through her vagina instead of through an incision in her abdomen. This is not the first time kidneys have been pulled from the body this way, but it is the first time such a procedure has been performed to remove a healthy organ.
The kidney was removed from Kimberly Johnson, 48, of Lexington Park, Md., who donated it to her ailing 23-year-old niece, according to the Associated Press. Johnson is among the first patients in the world to receive "natural orifice transluminal endoscopic surgery (NOTES)," a new procedure in which doctors remove organs and tissues through the body's natural openings—the mouth, the anus and the vagina—instead of via ones created in the skin by a surgeon's scalpel.
Mohamad Allaf, the urologist who performed the three-hour operation, says it went off without a hitch. Within minutes of extracting the kidney on January 29, another team of surgeons began the two-hour operation to transplant it into the recipient. Johnson was up and walking the same day—and released from the hospital the following morning. Allaf says she is "back to normal activity" and that the only restriction was a two-week ban on heavy lifting. (FYI: Her niece spent a few days in the hospital, which is typical after receiving a kidney transplant, and is also doing well, according to Allaf.) "It was easier than childbirth," Johnson, a mother of three, told the AP.
Does NOTES sound too good to be true? And if not, why isn't it used more often to spare patients the knife? We asked Wahid Wassef, a gastroenterologist at the University of Massachusetts Medical School in Worcester who has done extensive research on the procedure, to explain its pros and cons.
[An edited transcript of the interview follows.]
What is the advantage of removing an organ through the vagina, mouth or anus?
If you go through an orifice as opposed to an incision in the skin, the patient will have no scars. And the immune system appears to emerge stronger after these procedures compared to standard surgeries, which could result in fewer infections and faster healing. With no incision in the abdomen, you also eliminate the risk of hernias, which occur when part of the intestine pushes through the abdominal muscle. Let's say somebody has a gallbladder taken out the old-fashioned way; if it happens that one of the stitches in the abdominal muscle gives way, you have a weakness, and part of the intestine can push through that area forming a bulge under the skin. This is not an issue when no incisions are made in the abdomen.
How long have doctors been doing surgeries like this?
This procedure started about six years ago in humans; it had previously been done in animals.
How many times has the procedure been performed?
At least 15 procedures have been performed worldwide in addition to this one: this includes appendectomies (appendix removals) and cholecystectomies (gallbladder extractions) through the mouth and vagina.
How are kidneys usually removed?
Over the past 10 years or so, this has been done laparoscopically, which is a way of performing surgery using small openings. Doctors make two or three small incisions, each about a half inch, or the length of a staple, on the abdomen—usually one in the bellybutton, one a few inches above the bellybutton, and another a few inches to the side of the bellybutton. Through these incisions, they insert rigid plastic tubes or "ports," which are used to guide surgical instruments and scopes, or cameras, into the body. The scope allows you to visualize what you are doing; you have television monitors in the operating room that magnify images from inside the body by 10 or 20 times. A larger incision about six inches (15 centimeters) long is then made several inches below the belly button, and this is where the kidney is pulled out.
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11 Comments
Add CommentAmazing ...
Reply | Report Abuse | Link to thisI AM CHINESE
Reply | Report Abuse | Link to thisI LIKE SCIENTIFIC AMERICAN
It seems it's getting better and better to have a vagina nowadays.
Reply | Report Abuse | Link to thisDamn this Y chromosome. Think of have a kidney in a net pulled out through your anus and it doesn't seem as amazing.
Haha, just had a thought. If this becomes commonplace in the future, the urban legend about a man waking up in a bathtub full of ice with surgery scars will change to a waking up with a sore rectum.
Reply | Report Abuse | Link to thisI'm getting the shakes
Reply | Report Abuse | Link to thisI would not do it. First of all I don't have a vagina.
Reply | Report Abuse | Link to thisSecond, I just think that's silly. Why not go through the skin? A scar is the problem? We're talking about a kidney and it's a very vital organ.
The risks and the cost of the laparoscopic surgery are definitely higher and are not justified for cosmetic reasons only.
If one has to have a kidney removed, the last of their worries is the scar.
So you need a kidney huh?
Reply | Report Abuse | Link to this....
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Let me pull one out of my ass!
Hi, just joining. I agree with beznas!
Reply | Report Abuse | Link to thiswhat i wonder is if u ever come back from something like that? personally i would rather have a scar than b that lose! lol
Reply | Report Abuse | Link to thisTHAT IS INTERESTING, BUT . SCIENTISTS SHOULD THEN LEARN THAT ANY TECHNOLOGY THAT EMPLOYS THE NATURAL SURROUNDINGS IS SAFER
Reply | Report Abuse | Link to thisKEEP ON
KIMING ALFRED.
BAMENDA-CAMEROON
Had partial NOTES and partial laparoscopy(Birch) for a hysterectomy and bladder surgery and it's not about not having scars but about limiting the exposure of internal tissue to the air! You heal better and quicker and there is no infection when using sterile equipment and environment. It is much safer and I would do it again. It was very easy compared to traditional surgery.
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