- The Washington Times - Friday, July 18, 2008

CLEVELAND | Brad Kaster donated a kidney to his father this week, and he barely has a scar to show for it.

The kidney was removed through a single incision in his navel, a surgical procedure Cleveland Clinic doctors say will reduce recovery time and leave almost no scarring.

“The actual incision point on me is so tiny I’m not getting any pain from it,” Mr. Kaster, 29, said Wednesday. “I can’t even see it.”

Mr. Kaster was the 10th donor to undergo the procedure at the Cleveland Clinic. Dr. Inderbir S. Gill and colleagues at the research hospital Thursday were to perform the 11th such procedure, which Dr. Gill said could make kidney donations more palatable by sharply reducing recovery time.

More than 80,000 Americans are awaiting kidney transplants. Last year, there were about 13,300 kidney donors in the U.S., and about 45 percent were living donors, according to the Organ Procurement and Transplantation Network.

The first 10 recipients and donors whose transplants used the single-incision navel procedure have done well, according to the researchers. They report on the first four patients in the August issue of the Journal of Urology.

Preliminary data from the first nine donors who had the navel procedure showed they recovered in about just under a month, while donors who underwent the standard laparoscopic procedure with four to six “key hole” incisions took just longer than three months to recover.

The clinic says the return to work time for single-point donors is about 17 days, versus 51 for traditional multi-incision laparoscopic procedure.

“For me, that’s huge so I can get back to work,” said Mr. Kaster, a self-employed optometrist.

Patients of the new procedure were on pain pills fewer than four days on average, compared with 26 days for laparoscopic patients.

“This represents an advance, for the field of surgery in general,” said Dr. Gill, who predicted the bellybutton entry would be used increasingly for major abdominal surgery in a “nearly scar-free” way.

“Will this decrease the disincentive to [kidney] donation? I think the answer is yes,” Dr. Gill said.

Drs. Paul Curcillo and Stephanie King of Drexel University College of Medicine in Philadelphia developed a single-incision technique and Dr. Curcillo was the first to use the method to remove a woman’s gallbladder through her bellybutton in May 2007. They since have used it for a number of different kinds of surgery.

Dr. Curcillo said the navel procedure “will definitely make things better” for the donor. “A donor is one of the most altruistic people you’ll ever meet. He’s giving his kidney up. So anything you can do to make it better for that patient, they deserve it,” he said.

Laparoscopic surgery revolutionized the operating room more than 15 years ago, replacing long incisions with small cuts and vastly reducing pain and recovery time. Researchers now are exploring ways to eliminate scars by putting instruments through the body’s natural openings to perform surgery.

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