͹Ҥâ
   Donor kidney removed via vagina

The kidney is removed in a bag
US surgeons say they have successfully removed a healthy donor kidney through a small incision in the back of the donor's vagina.

Removing the kidney through "a natural orifice" speeds up recovery and gives a better cosmetic result - avoiding a six inch abdominal scar - they say.

The Johns Hopkins team say the 48-year-old woman who donated the organ to her niece on 29 January is "doing well".

Surgeons have also removed gallbladders and appendixes through the mouth.

Diseased gallbladders, kidneys and appendixes have been removed through the vagina before.

But this is believed to be the first time that doctors have managed to harvest a healthy donor kidney for transplantation in this way. Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result

Team leader Dr Robert Montgomery

Dr Robert Montgomery, chief of the transplant division at Johns Hopkins University School of Medicine, Maryland, who led the team that performed the operation, said: "Surgeons have been troubled by the need to make a relatively large incision in the patient's abdomen after completing the nephrectomy to extract the donor kidney.

"That incision is thought to significantly add to the patient's pain, hospitalisation and convalescence. Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result."

Cosmetically attractive

The operation left three pea-size scars on the Lexington Park woman's abdomen, one hidden in her navel, from where the wand-like camera and operating tools were inserted through small incisions.

Once the kidney was cut from its attachments to the abdominal wall and its arteries and veins were stapled shut, the surgeons placed the kidney in a plastic bag inserted through an incision in the vaginal wall and pulled it out through the vaginal opening with a string attached to the bag.

Dr Montgomery said the surgery took about three and a half hours, roughly the same as a traditional keyhole or laparoscopic procedure.

With keyhole surgery, an incision is typically made below the bikini line to remove the kidney.

The surgeons hope the new procedure will lead more women to become donors.

Anecdotal reports suggest living donor transplant numbers went up after keyhole procedures became available.

Dr Anthony Kalloo, the director of the Division of Gastroenterology at Johns Hopkins University School of Medicine, who pioneered the procedure, said: "Natural orifice translumenal endoscopic surgery is the final frontier to explore in making surgery scar-less, less painful and for obese patients, much safer."

In the UK, living donor kidney transplants are increasing - from 589 in 2005-2006 to 829 in 2007-2008 - and now represent more than one in three of all kidney transplants.

But the number of people on waiting lists for a transplant is also increasing - nearly 7,000 people were on the list last year and more than half of these will still be waiting for a donor, according to UK Transplant.

A spokesman for UK Transplant said: "Any development that is likely to boost donor numbers would be positive for people on waiting lists.

"Although 90% of people in the UK say that they are in favour of organ donation in principle, only 26% of the population have actually registered on the NHS Organ Donor Register. We need more people to join the register."

David Mayer, consultant transplant surgeon at the Queen Elizabeth Hospital in Birmingham, said: "This is quite interesting in terms of having scar-less surgery and because one of the obvious problems after surgery is pain.

"There might be some discomfort but nothing like having a wound the size of a kidney on the surface of the body which might cause pain for several weeks."


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   ԧ Ҥ餹ԨҤ żҵѴ
ԴԸչ͢
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Դ繷 2
   šդҧ褹
: ex-man [4 .. 52 17:50] ( IP A:114.128.129.23 X: )
Դ繷 3
   ҹ ͡

áʧ˹Ԥ

: ???? [5 .. 52 9:49] ( IP A:58.9.115.48 X: )
Դ繷 4
   Թѹҡ͡ҧͧʹ

䵨ж١ź͡㹶ا
ѰԡᾷǡҡźآҾռԹѹҡ䵼ҹºҡѧͧԹѹҡâͧ¹.

ź䵼ҹ "繸ҵԻҡ" ǿ鹵ǢŷբǡѺͧҧ - avoiding ˡǡѺͧ - ǡҡ.

͡ҧࡧٻᢹҡ Hopkins ٴ 48 ԨҤТͧ͹Ѵ 29 Ҥ "Ӵ".

ᾷź gallbladders appendixes ҹҡ.

ä gallbladders, kidneys appendixes ١ź͡ҧͧʹ͹.

繤áաèѴᾷآҾѺԹѹҡ㹡¡¹ҧ. ź䵼ҹҵԴպ觼¢ͧá׹ŷբ鹻з

ҹӴ. Montgomery

. Montgomery, ˹Ңͧǹ͡ҧࡧٻᢹ Hopkins Է¤ᾷʵŹӷҹջԷҾ÷ӧҹ "ᾷѺءµͧӡѷ˭ºҡʹͧ abdomen ѧҡ鹷 nephrectomy ¡.

"蹤ºҡԴѧӤѭͧ»Ǵ, hospitalisation Сÿ鹵. ź䵼ҹҵԴպ觡ʹͧá׹ŷբ鹻з."

Cosmetically ʹ

ôԹëǢҴ scars Lexington ʵ abdomen ˹ͫ͹㹹ըҡ͹ͧлԺѵԡͧͶ١áҹҴ incisions.

䵶١Ѵҡ觷Ṻ价ǡѺͧѧ arteries veins ١Դ stapled ᾷҧ㹶اʵԡʼҹºҡ㹷ǡѺ¹ռѧ pulled ͡ҹǡѺ¹ԴѺʵԧṺا.

. Montgomery ǡѺüҵѴФ觪ǡѹ繴١ح laparoscopic ͡кǹ.

١حᨴ¡üҵѴºҡ繻ԨзҹҧԡԹ÷Ѵź.

ѧҡᾷ鹵͹йҡҼ˭ԧ繼ԨҤ.

йӡԵ Anecdotal §ҹŢԹѹҡö仢ѧҡ١حᨡкǹá.

. Anthony Kalloo ӹ¡áͧ Gastroenterology ͡ҧࡧٻᢹ Hopkins Է¤ᾷʵ pioneered 鹵͹ "ҵԻҡ translumenal endoscopic ҵѴشԻǨ㹡üҵѴŧ-ѡ纻Ǵоǧռ, ҡʹ. "

ҪҳҨѡ, ôçԵԹѹҡ transplants - 589 ҡ 829 2005-2006 2007-2008 - йʴҡ˹ͧ transplants.

ӹǹͧªѺ¡ѧ - ͺ 7000 ¡ûԹҤ˹觢ͧҹѧѺԹѹҡõҪҳҨѡö.

繻ҡ§ҪҳҨѡá "þѲԹѹҡŢкǡѺ¡.

" 90% ͧҪҳҨѡáҾǡ㹤ôҹͧкԨҤѡ§ 26% ͧЪҡըԧ¹ NHS мŧ¹. Ҩ繵ͧؤŧ¹."

Դ Mayer, ֡ҶᾷŹ Queen Elizabeth çҺԧ, ҹ͹ҧʹ͹䢢ͧաüҵѴŧ-ͧҡ˹觷ѴѧҡüҵѴջѭһǴ.

"ҨպҧѡպҴŢҴͧ䵺鹼Ǣͧҧ«ҨԴҡûǴѻ. &



Сѹ ҹͧçѧ¨Ч¡¹
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Դ繷 5
   Donor kidney removed via vagina
䵢ͧԨҤ١͡ҷҧͧʹ

The kidney is removed in a bag
US surgeons say they have successfully removed a healthy donor kidney through a small incision in the back of the donor's vagina.
䵶١͡㹶ا
ᾷѰ ǡʺ䵷çͧԨҤ͡ҹҧ㹴ҹѧͧͧʹԨҤ䵹

Removing the kidney through "a natural orifice" speeds up recovery and gives a better cosmetic result - avoiding a six inch abdominal scar - they say.

The Johns Hopkins team say the 48-year-old woman who donated the organ to her niece on 29 January is "doing well".
͡ҧ ͧҵԔ ÿ鹵ǢͧԨҤǢ ŷҧҹ§ҡ ¡ա§ŷ˹ҷͧ 6 ᾷѧ ѧ

Surgeons have also removed gallbladders and appendixes through the mouth.

Diseased gallbladders, kidneys and appendixes have been removed through the vagina before.

But this is believed to be the first time that doctors have managed to harvest a healthy donor kidney for transplantation in this way. Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result

ᾷ ѧҶاӴ ͡ҧҡ
اӴշä ¶١͡ҧͧʹҡ͹˹ҹ
繤á͡ѹ ᾷʺ㹡䵷çԢͧԨҤẺ͹任١ ͡ҧͧԴҵԹҨз餹ԨҤ䵿鹵Ǣ Ŵҹ§ҡ
Team leader Dr Robert Montgomery

Dr Robert Montgomery, chief of the transplant division at Johns Hopkins University School of Medicine, Maryland, who led the team that performed the operation, said: "Surgeons have been troubled by the need to make a relatively large incision in the patient's abdomen after completing the nephrectomy to extract the donor kidney.

"That incision is thought to significantly add to the patient's pain, hospitalisation and convalescence. Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result."
˹ҷ ͹
͹ ˹Ἱû١зç¹ᾷԷ¨ ͻ ѰŹ 繼ӷ觼ҵѴ駹 ᾷӹǹҡջѭҵͧմżҵѴ͹ҧ˹ҷͧͼҵѴ͡㹡䵷բͧԨҤ͡
Ẻ 駤纻Ǵ褹 õͧѡçҺ Сÿ鹵Ƿͧҡ鹔 ͡ҧͧҵԹҨ餹鹵Ǣ Ŵҹ§ҡ

Cosmetically attractive

The operation left three pea-size scars on the Lexington Park woman's abdomen, one hidden in her navel, from where the wand-like camera and operating tools were inserted through small incisions.

Once the kidney was cut from its attachments to the abdominal wall and its arteries and veins were stapled shut, the surgeons placed the kidney in a plastic bag inserted through an incision in the vaginal wall and pulled it out through the vaginal opening with a string attached to the bag.
ѹйҷ§
üҵѴзŢҴ紶Ǻ˹ҷͧ˭ԧҨҡ硫ԧ աū͹д ŷͧͼҵѴСͧ觨ж١ʹҹ
ѧҡ䵶١ѴҴҡѹִԴ㹼ѧͧͧ ʹᴧͧ䵨ж١Ǵ˹պԴ ᾷ㹶اʵԡʹҹ价ҧͧʹ д֧ا͡ҷҧͧʹҹҧ͡١ԴѺا

Dr Montgomery said the surgery took about three and a half hours, roughly the same as a traditional keyhole or laparoscopic procedure.

With keyhole surgery, an incision is typically made below the bikini line to remove the kidney.

The surgeons hope the new procedure will lead more women to become donors.

Anecdotal reports suggest living donor transplant numbers went up after keyhole procedures became available.
͹ ҡüҵѴ 3 觾Ѻ㹡üҵѴԸͧͧ ͼҵѴԴ˹ҷͧ
ԸռҵѴͧͧ żҵѴ͡·仨СմdzͺԡԹ
ᾷ ѧ Ըзռ˭ԧҺԨҤҡ
§ҹҧ繷ҧ ӹǹժԵҺԨҤ䵹 ѧҡաüҵѴ͡¡üҵѴ͡ҧͧ

Dr Anthony Kalloo, the director of the Division of Gastroenterology at Johns Hopkins University School of Medicine, who pioneered the procedure, said: "Natural orifice translumenal endoscopic surgery is the final frontier to explore in making surgery scar-less, less painful and for obese patients, much safer."

In the UK, living donor kidney transplants are increasing - from 589 in 2005-2006 to 829 in 2007-2008 - and now represent more than one in three of all kidney transplants.
͹ⷹ 繼ӹ¡âͧἹҧԹ÷ç¹ᾷԷ¨ ͻ 繼㹡äԴԸչ üҵѴҧͧҹҧͧǵҵش㹡÷ФԴԸռҵѴ 纹¡ ੾Ѻǹѹʹ¡ҡ
ҪҳҨѡ üҵѴ١䵨ҡժԵըӹǹ ҡӹǹ 589 ҧ 2005-2006 829 ҧ 2007-2008 繨ӹǹҡ 1 3 ͧû١䵷

But the number of people on waiting lists for a transplant is also increasing - nearly 7,000 people were on the list last year and more than half of these will still be waiting for a donor, according to UK Transplant.

A spokesman for UK Transplant said: "Any development that is likely to boost donor numbers would be positive for people on waiting lists.
ӹǹͧͤѺüҵѴ١䵹鹡蹡ѹ ըӹǹͺ 7000 ͤ㹻շ ШӹǹҤ觡ѧͼԨҤ 駹ŢͧüҵѴ١ТͧҪҳҨѡ
ɡͧͧû١ТͧҪҳҨѡ þѲáӹǹԨҡͧѺѧͤǼҵѴ


"Although 90% of people in the UK say that they are in favour of organ donation in principle, only 26% of the population have actually registered on the NHS Organ Donor Register. We need more people to join the register."

David Mayer, consultant transplant surgeon at the Queen Elizabeth Hospital in Birmingham, said: "This is quite interesting in terms of having scar-less surgery and because one of the obvious problems after surgery is pain.

"There might be some discomfort but nothing like having a wound the size of a kidney on the surface of the body which might cause pain for several weeks.&
90 % ҪҳҨѡá繴¡ѺѡúԨҤ §ӹǹ 26 %ͧҪҳҨѡ÷ŧ¹ԧѺͧŧ¹ԨҤТͧ ʻʪ (30 ҷ) ҪҳҨѡ ҵͧèӹǹŧ¹ԨҤ鹔
Դ ᾷ֡ҴҹҵѴ١ТͧçҺŤչԫԧ ͧ͹ҧʹҡͧüҵѴ лѭաҧѧüҵѴѴͧ纻Ǵ
ѹͧͧ纻Ǵҧ è͹Ѻ÷ŢҴ䵺ҧ¢ͧԨҤзԴ纻Ǵѻ.....
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