Lahey Transplant - Living Kidney Donor

10. Donation Surgery

Our preferred surgical method to harvest donor kidneys a laparoscopy (explained below). Surgeons prefer to remove the left kidney because it sits higher, and has longer blood vessels, ureter, and supportive anatomy, which make it easier to reconnect it to the recipient’s body. The operation lasts about 3 hours.

Laparoscopy vs. Open Surgery

We prefer to perform a laparoscopic surgery over the traditional open surgery because it’s a minimally-invasive procedure. A laparoscopy consists of three small incisions, or “ports”, that are half the width of a dime (¼-inch) through which we insert a camera and other robotic tools to detach the kidney. Once detached, the kidney can be removed through the bellybutton or a 3” incision below the waistline. On the other hand, an open surgery requires a much larger incision alongside the kidney, which leads to more pain, a longer recovery period, a longer hospital stay, and a more visible scar than with a laparoscopy.

First Port

Our surgeon will make an incision on the side of the navel and connect a tube that will expand the abdominal cavity with gas to allow for room to maneuver. Carbon dioxide is preferred because it’s a transparent gas that occurs naturally within the body, it is easily absorbed into the bloodstream and expelled through the lungs, and it is non-flammable. Once the abdomen has been expanded, this port will be used to insert surgical tools.

Second and Third Ports

The second port will be made after expansion of the abdomen, and will be used to introduce a small camera (laparoscope) through the upper part of the navel. The camera has a light source, and transmits its images to a nearby monitor through which the surgeon can look into the abdomen.

The third port will be made next to the kidney, and will be used to alternate between other surgical instruments.

Vessel Detachment

The renal artery and renal vein are clamped down to stop blood flow to the kidney. Once blood flow has ceased, the vessels are cut.

The ureter, which drains urine from the kidney to the bladder, is also clamped down to avoid urine leakage and then cut. The kidney has many tissues and fibers that hold it in place, so these will have to be severed as well before the kidney is completely loose.

Kidney Extraction

To withdraw the kidney, we'll need to make a 3” incision on the waistline. A sterilized plastic bag is inserted into the abdomen, and the kidney is placed inside to protect it from infection. It is then taken out through the new incision. One of the assistants will flush the kidney with a preservative solution and transport it to the adjacent operating room, where the recipient's surgery will already be underway. Here it will be prepared for transplantation into the recipient’s body. The surgeons will suture the incisions, and send the donor to the Post-Anesthesia Care Unit (PACU) for recovery and monitoring.