Minimally Invasive Kidney Transplantation

abstract

Minimally invasive procedures have in recent years gained widespread acceptance. Within the field of transplantation laparoscopic living donor nephrectomy (LLDN), requiring a 6-10 cm incision, is now considered the optimal procedure. According to recent MEDLINE searches, no minimal invasive techniqu...

e has been reported for kidney transplantation. Considering the rapid evolution of minimal invasive surgery during the last decade, there is little reason to believe that kidney transplantation in future will be excluded from this development. A novel minimal invasive technique for kidney transplantation (MIKT) is presented; restricting to a 7-9 cm incision, and attempting minimal dissection/tissue trauma. The kidney is meticulously prepared backtable and placed in a fitting, lateral, retroperitoneal pouch. All three anastomoses are performed with the kidney in its final “in situ” position, and ureter reimplantation is done by extravesical technique. Twentyone patients have been transplanted by MIKT and followed in a prospective manner, along with a matched control group subjected to conventional kidney transplantation Our results indicate that MIKT may be executed safe and fast. Beneficial effects on postoperative pain/analgesia, recovery and complications are suggested by this first MIKT experience. The technical solutions of MIKT are ‘per se’ not unique. However, the incision is minimal, and not larger than the one required for LLDN. Minimal invasive surgery seems particularly attractive in the immunosuppressed population - and even more so with the recent introduction of potent antiproliferative drugs.

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