A new procedure removes kidneys through the bellybutton, minimizing scars and recovery time.

Drs. Paul Curcillo and Stephanie King of Drexel University College of Medicine in Philadelphia developed a single-incision technique. Curcillo first used the method to remove a woman's gallbladder through her bellybutton in May 2007. Since then, it has been used for a number of different kinds of surgery.

Over 15 years ago, laparoscopic surgery revolutionized the operating room by replacing long incisions with small cuts, vastly reducing pain and recovery time. Now, researchers are exploring ways to eliminate scars by using natural openings in the body, like the mouth nose and vagina, to place instruments though for surgery.

The Cleveland clinic has developed a method that uses the bellybutton to minimize the appearance of a visible scar for kidney donors, although it is not used for transplant into the kidney recipient. Dr. Inderbir S. Gill said the technique could make kidney donations more palatable by sharply reducing recovery time. Gill and he has begun training other surgeons on the procedure, which was approved by the clinic's internal review board as an extension of its laparoscopic surgical work.

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

At the time of the article, about 11 patients had donated using the bellybutton procedure. Initial reports showed that the first 9 donors recovered in just under a month. Donors that underwent the standard procedure took slightly over 3 months to recover. Patients on the new procedure also used pain pills for less time; an average of 4 days rather than the 26 days for the traditional laparoscopic patients.

Gill predicts that bellybutton entry will be increasingly used for major abdominal surgery said, "This represents an advance, for the field of surgery in general.”

Gill also said, “"Will this decrease the disincentive to (kidney) donation? I think the answer is yes."

The AP article explains:

The procedure involves making a three-quarter inch incision in the interior of the bellybutton and inserting a tube-like port with several round entry points for inserting a camera and other tools into the belly.

The belly is inflated with carbon dioxide to provide maneuvering room. The kidney is then freed from connecting tissue, wrapped in a plastic bag and removed through the navel when the blood supply is cut, shrinking the organ's fist-like size. The incision is expanded to about 1 1/2 inches to extract the kidney after the port is removed.

Gill warned that the procedure would not be appropriate for those who have had multiple major abdominal surgeries or who are obese, as both conditions would limit the ability to look around the abdomen and move about instruments.

Researchers have said that the first 10 recipients and donors who used the single-incision navel procedure for their surgery have done well. The August issue of the Journal of Urology reports on the first four patients.

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