Hands on Kidney Removal: July 10, 2014

When urologist Paul Bretton diagnosed a patient with kidney cancer, it was clear the diseased organ had to come out.

“Yes, it’s fortunate that you have two kidneys so you can live with one,” says Dr. Bretton who is on the medical staff of Lee Memorial Health System.

For years the surgery was a traumatic undertaking, requiring surgeons to make a foot-long incision to remove the kidney. Nowadays many are taking a ‘hands on’ approach that is more gentle on patients.

“The way I do these is called ‘hand-assisted laparoscopically’. Hand assisted meaning I’m able to make a small incision, put my hand inside the abdomen to be able to assist with the removal of the kidney,” says Dr. Bretton.

The combination of smaller instruments used with a specially designed port gives doctors the access they need while making a smaller incision.

“The advantages of doing it laparoscopically vs. open is, one, the patient’s blood loss is a lot less, their hospital stay is a lot less, they use less narcotics; and the return to work is significantly shorter,” says Dr. Bretton.

The hand-assisted approach also opened up new possibilities for kidney donation. The less traumatic surgery makes it more viable for living donors to share a kidney.

“We have had a huge increase in the number of donors stepping forward now that they know that this option is available to them,” says Barbara Miller, director of renal transplant for Lee Memorial Health System.  “Most of our donors, you have to remember, they’re young, they are otherwise healthy, and many of them are working.”

The hand-assisted approach takes longer to perform because tissue is preserved for transplantation. But taking the procedure in hand shrinks downtime by several weeks.