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 Satellites, airport visibility readings shed light on troops' exposure to air pollution
09.12.2016 | Veterans Affairs Research Communications

nachricht Oxygen can wake up dormant bacteria for antibiotic attacks
08.12.2016 | Penn State

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: Electron highway inside crystal

Physicists of the University of Würzburg have made an astonishing discovery in a specific type of topological insulators. The effect is due to the structure of the materials used. The researchers have now published their work in the journal Science.

Topological insulators are currently the hot topic in physics according to the newspaper Neue Zürcher Zeitung. Only a few weeks ago, their importance was...

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

Researchers identify potentially druggable mutant p53 proteins that promote cancer growth

09.12.2016 | Life Sciences

Scientists produce a new roadmap for guiding development & conservation in the Amazon

09.12.2016 | Ecology, The Environment and Conservation

Satellites, airport visibility readings shed light on troops' exposure to air pollution

09.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>