Dr Shyam Varma has extensive experience and expertise in performing minimally invasive surgery to remove a donor's kidney (laparoscopic donor nephrectomy) for a kidney transplant, as an alternative to open surgery.
WHAT IS NEPHRECTOMY?
Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. There are two types of operation performed to remove the kidney, the traditional “open” technique and laparoscopic commonly referred as “key hole or minimal invasive” surgery. The procedure is done to treat kidney cancer as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor (either living or deceased) for transplantation.
WHAT IS DONOR NEPHRECTOMY?
In a donor nephrectomy, a kidney is transplanted from a living donor to a recipient, the patient. Traditionally, a live donor nephrectomy required a healthy individual, the donor, to undergo a major operation where the kidney was removed through an incision in the side using a large incision. This so-called "open" procedure was associated with significant pain and a substantial recuperation period for the donor.
WHAT ARE THE DISADVANTAGES OF “OPEN “ TRADITIONAL NEPHRECTOMY?
Disadvantages of open nephrectomy includes:-
- A larger scar
- Weakness of abdominal muscle support with tendency to develop a bulge at the site of incision
- Higher chance of chronic pain in the scar
- Longer hospital stay
- Delayed return to work compared to laparoscopic donor nephrectomy
WHAT IS LAPAROSCOPIC DONOR NEPHRECTOMY?
In contrast, in a laparoscopic donor nephrectomy, tiny 3-4, a centimetre long incisions are used and the kidney is removed using a scope or camera and special miniaturized surgical instruments. The procedure is, similar to one used to remove a gall bladder. Donor kidney is retrieved through a small lower abdominal incision. This minimally invasive procedure has a shorter recovery period and the complication rate is very low. In addition, the quality and function of the transplanted kidneys are comparable to traditional open technique.
WHAT ARE THE ADVANTAGES OF LAPAROSCOPIC DONOR NEPHRECTOMY?
Laparoscopy achieves the same things as traditional “OPEN”surgical techniques. It is also the preferred method for kidney transplant donor nephrectomy.
The advantages of laparoscopic surgery include:
- Shorter recovery time
- Shorter hospital stay
- Smaller incisions
- Fewer post-operative complications
Laparoscopic nephrectomy takes special skills to perform and is not available at all hospitals.
WHAT ARE THE RISKS OF THE OPERATION?
There are risks and benefits associated with kidney donation for both prospective recipient and donor. However, with laparoscopic donor nephrectomy, you have a quicker recovery, a shorter hospital stay and less pain than after open surgery. Many kidney donors return to their normal activities or job within a few weeks of donating a kidney.
All surgeries carry risk, no matter how small it is. Most common risks associated with donor nephrectomy are minor and can be managed appropriately. These include wound infection, urinary tract infection,pain.
Other being bleeding which might happen in < 0.5 % of the patients. At Pace hospital,expert healthcare team is experienced in dealing with such situations quickly and appropriately.
WILL I HAVE PROBLEM IN FUTURE IF I DONATE ONE OF MY KIDNEYS?
You are born with two kidneys, but you really only need one. A single healthy kidney can work as well as two kidneys , unless you have compromised functioning kidneys. The vast majority of kidney donors live long and healthy lives with one kidney.
Few tests will be done on a regular basis to check how well the remaining kidney is working. A urinalysis (urine test) and blood pressure check should be done every year, and kidney function tests may be checked every few years.