Surgeon removes a diseased kidney through the belly button

Apr 22 2009

A surgeon at the University of Illinois Medical Center at Chicago is one of the first in the Midwest to use a new surgical technique that requires only one small incision to remove a diseased kidney.

Dr. Leslie Deane, assistant professor of urology and director of laparoscopy, endourology and robotic urologic surgery at UIC, inserted a camera and two surgical instruments through a port placed in a one-inch incision in the patient's belly button and remove a diseased kidney the size of an orange.

Surgical techniques have been advancing, as better surgical instruments and the introduction of cameras inside the body have made it possible to operate through small incisions. While laparoscopic approaches generally have fewer complications, shorter hospital stays, and faster recovery times than open surgery, they still usually require three to five incisions, each with attendant risks of bleeding, hernia, and scarring.

The technique called single incision laparoscopic surgery, or SILS, "gives us better pain control following surgery," said Deane. "And, of course, there is a much better cosmetic outcome for many patients. The small scar essentially disappears into their belly button."

Deane's surgical team included his chief resident Dr. Alexis Chesrow and senior resident Dr. Hector Pimentel and the nursing staff Elrayna Aten, RN and Annie Marrs, RN.

Chicago resident Eddie Bibbs, 55, is the mother of four grown children and has a number of grandchildren. She says she is not planning on wearing a bikini anytime soon, but was grateful that the simple incision kept bleeding to a minimum during her April 16 surgery to remove a diseased kidney. "I didn't need any transfusion at all," she said.

Bibbs' kidney had become infected months before, requiring insertion of a tube through the back. The kidney eventually failed, necessitating removal. She has been in and out of the hospital since last November and said she had barely been able to leave her house all winter.

On Friday, the day following the three-and-a-half-hour surgery, Bibbs was up walking the hallways of the hospital and looking forward to going home the next day.

"My daughter said I sound much better and I look much better," Bibbs said.

And, she added, "I feel much, much better!"

Deane expects SILS to become a more common procedure as new instruments are developed that are better adapted to the technique. The trend in surgery today is towards minimizing the size and number of incisions to reduce complications and scarring and improve recovery, he said. And with improvements in robotic technologies, the possibilities will be endless.

"I was also surprised to find that I was able to perform the surgery as quickly and safely through the single port as I would have expected from ordinary laparoscopic surgery," said Deane. "In 2009, the indications for 'open' kidney surgery are few."