What Are the Benefits of Transvaginal Route for Kidney Extraction in Laparoscopic Living Donor Nephrectomy ?
1Hôpital Européen Georges Pomidou, Paris, France
2Hôpital Necker, Paris, France.
Meeting: 2016 American Transplant Congress
Abstract number: C149
Keywords: Donors, Kidney transplantation, Laparoscopy, Safety, unrelated
Session Information
Date: Monday, June 13, 2016
Session Name: Poster Session C: Kidney Donor Evaluation and Donor Nephrectomy
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Rationale and objectives
Transvaginal route for kidney extraction (TVE) emerged as new surgical option during laparoscopic donor nephrectomy to minimize scar and presumably to offer donors cosmetic advantages and decreased post-operative pain. However, no evidence exists regarding the potential aesthetic and corporal satisfaction. The aim of this study was to assess aesthetic and cosmetic satisfaction, body perception, and post-operative pain associated with this surgical artifice.
Methods
From January 2012 to April 2013, 41 female donors underwent laparoscopic nephrectomy at our institution. In the absence of contra-indication (n=29), patients were offered to choose between transvaginal (group 1, n=10) or transabdominal (group 2, n=18) route for kidney extraction after detailed informed consent and acceptance of study participation. At 6 months post surgery, all patients answered the Body Impact Questionnaire (BIQ) including 5 items related to body perception (score ranges 5 to 20) and 3 items to evaluate scare perception (score ranges 3 to 21), higher score being better satisfaction. Morphine administration during hospital stay was reported to assess post-operative pain.
Results and conclusions
No significant difference was observed regarding body and scare perception scores between group 1 and 2, with median scores respectively 7.6 (5-9) vs 8 (6-15) and 20.1 (13-24) vs 18 (11-23). All scar dissatisfactions concerned abdominal trocars incisions.
Mean morphine consummation was significantly inferior in group 1 vs 2, with respectively 15mg and 28mg of drug administration (p<0.03)
Our data indicate that despite the potential benefits of transvaginal route for kidney extraction, this artifice does not provide donors with improved body perception or scar satisfaction since trocars scars – and not kidney extraction incision- are responsible for donors dissatisfaction. Interestingly, transvaginal route significantly reduces post-operative morphine administration.
CITATION INFORMATION: Hurel S, Ariane M, Audenet F, Legendre C, Mejean A, Timsit M.-O. What Are the Benefits of Transvaginal Route for Kidney Extraction in Laparoscopic Living Donor Nephrectomy ? Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Hurel S, Ariane M, Audenet F, Legendre C, Mejean A, Timsit M-O. What Are the Benefits of Transvaginal Route for Kidney Extraction in Laparoscopic Living Donor Nephrectomy ? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/what-are-the-benefits-of-transvaginal-route-for-kidney-extraction-in-laparoscopic-living-donor-nephrectomy/. Accessed May 27, 2020.« Back to 2016 American Transplant Congress