Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Single-port kidney removal through the belly button boosts living-donor satisfaction

13.09.2012
University of Maryland study findings advance navel nephrectomy as standard of care
In the largest study of its kind, living donors who had a kidney removed through a single port in the navel report higher satisfaction in several key categories, compared to donors who underwent traditional multiple-port laparoscopic removal.

The new technique has been described as virtually scarless, because nearly the entire incision, once healed, is hidden within the belly button. Researchers at the University of Maryland School of Medicine in Baltimore found the belly button group had significantly improved satisfaction with the cosmetic outcome and the overall donation process. Additionally, the new technique was associated with fewer limitations in bending, kneeling or stooping following surgery, and slightly less pain after surgery, compared to the multi-port approach. At the same time, the study found the two procedures equally safe. The results are published online today in the Annals of Surgery.

“Everything we do in organ transplantation is based on the generosity of organ donors,” says lead author Rolf Barth, M.D., associate professor of surgery at the University of Maryland School of Medicine and transplant surgeon at University of Maryland Medical Center. “If we as surgeons can safely improve the donation process for our living donors by perfecting less-invasive surgical options, we should embrace these new approaches.”

Single-port donor nephrectomy (kidney removal), also known as laparoendoscopic single-site (LESS) surgery, has been the standard of care for living kidney donors at the University of Maryland Medical Center (UMMC) for the past three years; however, no objective data previously existed to compare the single-port with the multiple-port laparoscopic techniques. UMMC is only the third hospital in the country to consistently use this surgical approach on living donors and, to date, has employed the single-port technique in 215 donors.

“Once this surgical procedure came to our attention, we wasted no time in adopting this as our standard technique in 2009,” says senior author Benjamin Philosophe, M.D., Ph.D., associate professor of surgery at the University of Maryland School of Medicine and Head, Section of Liver Transplantation and Hepatobiliary Surgery at the University of Maryland Medical Center. “It seemed like the logical next step in the surgical evolution of living donation.”

The researchers took a two-pronged approach. They analyzed the surgical results of 135 single-port and 100 multi-port donors from the UMMC patient database and measured transplant outcomes. They also sent two questionnaires to 100 single-port patients and a group of 100 multi-port donors – all of whom had their procedures performed by the same surgeons with similar laparoscopic equipment at the University of Maryland Medical Center.

The analysis determined that LESS surgery is a safe option for kidney donation without increasing risks or complications to the donor. Single-port nephrectomy leaves only one small scar in the center of the navel, which typically fades over time. The multi-port approach leaves several scars. Beyond the cosmetic benefit, the data suggested single-port donors were more satisfied with their donation decision. “For a living kidney donor who leaves the operating room with no health benefit from the surgical procedure and only a small band-aid over the umbilicus, LESS may be more,” says Barth.

“The single-port donor nephrectomy operation is more technically challenging than the standard multiple-port donation technique used nearly everywhere else in the U.S.” says Stephen T. Bartlett, M.D., the Peter Angelos Distinguished Professor; chair, Department of Surgery at the University of Maryland School of Medicine; and surgeon-in-chief at the University of Maryland Medical System. “Our Division of Transplantation has a long-standing reputation for leading the way in transplant innovation, and our surgeons are handpicked for their ability to master complex surgical techniques and consistently try to make the patient’s experience as safe and effective as possible.”

“Our transplant surgeons work tirelessly to assess and improve every angle of the transplant process,” says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs, University of Maryland; the John Z. and Akiko K. Bowers Distinguished Professor; and dean, University of Maryland School of Medicine. “The standard of care elsewhere is not good enough for our patients, and this team of surgeons continues to impress me with their commitment to the advancement of medicine through surgical excellence.”

The UMMC transplant team is conducting workshops to train other transplant surgeons in the LESS technique, and has been selected to author a chapter on this technique in the surgical textbook Kidney Transplantation.

This study on single-port donor nephrectomy is a natural milestone in the surgical advancement of living kidney donation. In 2003, UMMC urologist Michael W. Phelan, M.D., a co-author of this Annals of Surgery paper, published a study on the advances in laparoscopic nephrectomy, which accurately predicted the increased use and standardization of laparoscopic techniques for kidney donation.

According to the Organ Procurement and Transplantation Network (OPTN), as of June 1, 2012, more than 92,000 people are on the kidney transplant waiting list in the U.S. Living donation can help many patients receive a transplant sooner and avoid dialysis or deteriorating health that often occurs while waiting for a transplant from a deceased donor.

The University of Maryland Division of Transplantation, which focuses on kidney, pancreas and liver transplantation, is one of the nation’s largest transplant programs, set to exceed 400 transplants in 2012. The Division offers living donation as an option for liver and kidney patients to decrease patient wait times and improve patient outcomes.

About the University of Maryland School of Medicine,
University of Maryland Medical Center

Founded in 1807, the University of Maryland School of Medicine in Baltimore is the oldest public medical school in the United States, and the first to institute a residency training program. The School of Medicine was the founding school of the University of Maryland and today is an integral part of the 11-campus University System of Maryland. The partnership between the University of Maryland Medical Center (UMMC) and the University of Maryland School of Medicine allows cutting edge medical research and discovery to rapidly innovate and improve patient care and prepare the next generation of health care professionals through excellent training and education.
The University of Maryland Medical Center (UMMC) is a 779-bed teaching hospital in Baltimore and the flagship institution of the 11-hospital University of Maryland Medical System. Patients are referred nationally and regionally for advanced medical, surgical and critical care. All physicians on staff at the Medical Center are faculty physicians of the University of Maryland School of Medicine.

Barth RN, Phelan MW, Goldschen L, Munivenkatappa RB, Jacobs SC, Bartlett ST, Philosophe B. “Single-port donor nephrectomy provides improved patient satisfaction and equivalent outcomes.” Annals of Surgery. DATE NEEDED DOI: 10.1097/SLA.0b013e318262ddd6

Media Contacts:

Bill Seiler (bseiler@umm.edu)
Karen Lancaster (klancaster@umm.edu)
410-328-8919

Bill Seiler | EurekAlert!
Further information:
http://www.umm.edu

More articles from Health and Medicine:

nachricht Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Osaka university researchers make the slipperiest surfaces adhesive

18.10.2017 | Materials Sciences

Space radiation won't stop NASA's human exploration

18.10.2017 | Physics and Astronomy

Los Alamos researchers and supercomputers help interpret the latest LIGO findings

18.10.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>