First Euro Kidney Transplant Using Keyhole Surgery
The first kidney transplant using keyhole surgery in Europe has been carried out at the Royal Liverpool University Hospital, paving the way for better and safer surgery in the future.
Keyhole surgery – or laparoscopy, as it is medically known – has been used to remove kidneys from donors since the 1990s. However, implanting the organs normally involves open surgery and leaves a scar of between 20 and 25 centimetres (8 to 10 inches).
But now the team of surgeons at the Royal Liverpool have successfully implanted a kidney into a patient using the same laparoscopic method – through an incision less than a third of the size than in previous operations.
The technique was developed in India by Professor Pranjal Modi at the Institute of Kidney Disease and Research Centre (IKDRC). He performed the procedure in Liverpool while being observed by visiting surgeons from across Europe, teaching them so that the technique can become more widespread.
“[Keyhole surgery] is tremendously beneficial to the patient,” Professor Modi explained. “I talk one-to-one to all the patients and they are so happy. Their outcomes are so good that I am encouraged to do it further and further.”
The patient in this case was 51-year-old Brian Blanchfield. In 1985, Brian was diagnosed with a condition called nephritis, which is inflammation of the kidneys. He has spent years living with a failing kidney, and up until recently was using medication to control his illness.
Over the past couple of years, however, Brian’s kidney function has deteriorated so dramatically that he started feeling tired and lethargic. His sister, Pam Morfett, said that if it comes to a time when he needed a new kidney – and the pair were a match – then he could have one of hers. “When my kidney function dropped to 10%, I needed one,” Brian said.
So, after it was established that Brian and Pam were a match, and they had been tested and interviewed, an appointment was made for them at the Royal Liverpool, and the operation took place.
Brian was informed that he would be the first person to undergo this kind of surgery for a kidney transplant, and he was asked if he had a preference of where to insert the organ. As he already had a scar from an appendectomy, he asked that they go through there to avoid new scarring.
And only four days after the operation, Brian was up and about.
“The renal team has been superb,” he declared. “Every step of the way, they have talked us through it. They explained how the op would go and how I would feel afterwards and everything has been exactly as they said.”
Royal Liverpool transplant surgeon, Dr Sanjay Mehra explained that there are many benefits to using keyhole surgery over open surgery. High up on that list of benefits is a smaller scar (only 6cm/2in), which reduces the risk of infection for the patient and ultimately leads to a faster recovery time. “We will now monitor the long-term outcomes for the patient,” he added.
The technique isn’t intended for use in every kidney transplant, but is a more suitable option for patients for whom major abdominal surgery carries greater risk.
What the whole event demonstrates is that new methods can be developed for even the most complicated of operations, and is sure to inspire doctors to look into alternatives to serious open surgery.