title: Minimal access kidney transplant: a novel technique to reduce surgical tissue trauma.
abstract: OBJECTIVE
  Minimally invasive surgery and minimal access surgery has replaced conventional surgical procedures during the last 15 years with benefits including a decrease in postoperative pain, time spent convalescing, early return to normal activities, and pleasing cosmetic results. Many centers perform kidney transplant through an oblique or J-shaped approach deep into the iliac fossa. Both approaches have possible disadvantages regarding the extent of tissue trauma. Therefore, we introduced a new minimal access kidney transplant technique in our kidney transplant program in 2008 and report the outcomes of the first 10 patients transplanted with this technique.
  
  
  METHODS
  Between November 2008 to May 2009, ten kidney recipients were subjected to the minimal access kidney transplant technique. These patients represent a consecutive series of kidney transplants performed by the senior surgeon or under the supervision of the senior surgeon of transplant surgery.
  
  
  RESULTS
  The mean (± SD) age of the recipients was 47 ± 14.7 years (range, 28-67 y), the body mass index was 25 ± 2.02 (range, 23-30), the time of procedure was 126.2 ± 27.5 minutes (range, 90-165 min) with a mean (± SD) anastomoses time of 27.7 ± 8.4 minutes (range, 19-45 min). Follow-up for all recipients was at least 18 months. There was no reintervention necessary, no wound infections, no primary nonfunction or a delayed graft function, no need for dialysis, no acute rejection episodes, no graft loss, no wound dehiscence, no incisional hernia, or lymphocele. Furthermore, no urologic complications or vascular complications were observed.
  
  
  CONCLUSIONS
  Our reported technique was used on heart-beating donor kidneys as well as on living-donor organs and is safe with less comorbidity. This minimal access kidney transplant technique might be an alternative procedure for avoiding some of the disadvantages of conventional approaches used for kidney transplant.
authors: Department of General-, Visceral-, and Transplantation Surgery, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany. Claas.Brockschmidt@uniklinik-ulm.de
authors: Claas
authors: C
authors: Brockschmidt
authors: Nadine
authors: N
authors: Huber
authors: Stephan
authors: S
authors: Paschke
authors: Bertram
authors: B
authors: Hartmann
authors: Doris
authors: D
authors: Henne-Bruns
authors: Mathias
authors: M
authors: Wittau
mesh_terms: D000328:Adult; D000368:Aged; D005858:Germany; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome