Minimally invasive renal auto-transplantation: the first report.
BACKGROUND
Regarding transplant surgery, the minimally invasive revolution was started in 1995 by laparoscopic living donor nephrectomy (L-LDN). In 2006, we made the first report on a minimally invasive technique for kidney transplantation; restricted to a 7-9 cm transverse incision targeted on the anastomotic area of the iliac vessels, and with the meticulously prepared kidney placed in a fitting, retroperitoneal pouch lateral to the skin incision.


METHODS
By combining "hand-assisted laparoscopic nephrectomy" and "minimally invasive kidney transplantation" - using the same incision (7-8 cm) for hand-assistance, kidney harvesting, and transplantation - we have during 2009 conducted "minimally invasive renal auto-transplantation" in two patients.


RESULTS
In both cases, the postoperative course was uneventful. When examined 3 mo postoperatively, both auto-transplants were shown to have excellent function by renal scintigraphy.


CONCLUSIONS
Renal auto-transplantation, a traditionally major surgical procedure, can be made minimally invasive by a similar incision as that used for L-LDN. Taking into regard the highly traumatic conventional incisions, we expect the generally proven minimally invasive benefits to be considerable.
Øyen
Ole
O
Department for Transplant Surgery, Oslo University Hospital, Rikshospitalet, Clinic for Specialized Medicine and Surgery, Oslo, Norway. ole.oyen@rikshospitalet.no
Lien
Bjørn
B
Line
Pål-Dag
PD
Pfeffer
Per
P
D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*