Keyhole Surgery is a revolutionary boon for living kidney donors

Keyhole Surgery is a revolutionary boon for living kidney donors. Surgeons inflate the donor's abdomen during the procedure to make small keyhole-sized incisions. A laparoscope (a tiny fiber optic camera) is inserted, along with long instruments used to sever blood vessels and detach the kidney. Living donation is now accounting for nearly 40% of all kidney transplants performed in Canada. Live donor kidneys typically last twice as long as cadaveric donors' kidneys. The Kidney Foundation of Canada has been supporting the work of Canadian researchers involved in laparoscopic surgery since 2001.

Every year, an increasing number of Canadians make the difficult decision to donate one of their kidneys to a family member or friend in need.

While this life-saving act is a blessing for the recipient, it can present difficulties for the donor on several levels. Making a 20- to 30-centimetre incision across the side of the body, going through two to three layers of muscle, and removing 10 centimetres of rib is standard procedure for removing a kidney. With scarring and several months of inactivity, the decision to be a donor is understandably intimidating for many.

However, thanks to a groundbreaking medical procedure known as laparoscopic or "keyhole" surgery, painful incisions and lengthy recovery times may soon be a thing of the past.

"When compared to traditional methods, keyhole surgery is major abdominal surgery without uncomfortable incisions and disfiguring," said Dr. Joseph Mamazza, lead surgeon and medical director of St. Michael's Hospital's Minimal Access Therapeutic Program in Toronto. "It entails an 8 to 10 centimetre cut in the groin area, which reduces the risk of infection and other complications."

Doctors inflate the donor's abdomen during the procedure to make small keyhole-sized incisions. After that, a laparoscope (a tiny fiber optic camera) is inserted, along with long instruments used to sever blood vessels and detach the kidney.

Glenn Collins underwent the first laparoscopic kidney retrieval in Southern Alberta two years ago to help his diabetic older brother, Michael, who was diagnosed with kidney disease in 1997. Glenn's gift gave Michael new hope, especially since his brother was deemed an unlikely candidate for a transplant due to his age and medical history.

Glenn, an outspoken supporter of organ donation, approached a clinic in Calgary about becoming a live kidney donor after researching laparoscopic surgery on the Internet.

"It was an easy decision because Michael was in need," Glenn explained. "While any member of our large family could have answered the call, I stepped up because I was the youngest and fittest, and I passed all of the tests to determine if I was a suitable donor."

Glenn recalls waking up the day after surgery and walking the long corridor to Michael's room when asked about his recovery.

"If it hadn't been for the scar, I would never have known I'd had surgery!" he exclaimed.

Laparoscopic surgery, according to Dr. Mamazza, is advantageous for a variety of reasons. For starters, live donor kidneys typically last twice as long as cadaveric donors' kidneys - people who died suddenly as a result of some kind of trauma. Furthermore, live donors who undergo laparoscopic surgery have less post-operative discomfort and usually recover faster, with their hospital stay reduced from a few months to a few days.

"Keyhole surgery goes a long way toward reducing donor and recipient anxiety," Dr. Mamazza said.

Living donation is now accounting for nearly 40% of all kidney transplants performed.

In February 1995, the world's first live donor keyhole surgery procedure was performed at Johns Hopkins Hospital in Baltimore. The Kidney Foundation of Canada has been supporting the work of Canadian researchers involved in the study of laparoscopic procedures since 2001.

The Kidney Foundation of Canada is the only national health charity that funds research, provides educational and emotional support services, advocates for access to high-quality healthcare, and actively promotes awareness and commitment to organ donation.