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KEYHOLE SURGERY

        Depending on the donor’s anatomy             ST DAMIEN’S RENAL TRANSPLANT WARD
        and preference and the surgeon’s
        decision, the surgery might be
        performed through an incision below
        the ribs or by a ‘keyhole’ incision. The
        advantage of the keyhole incision is
        that it allows the incision to remove
        the kidney to be sited lower down in
        the abdomen, which is generally not
        as sore post-operatively. This incision
        also allows the surgeon to place their
        hand into the abdomen to facilitate
        the dissection of the kidney.
           However, if the keyhole method is
        adopted and the surgeon has to
        convert to the traditional open
        surgical method, for whatever reason, then the        administered via a drip, and because the incision
        donor will have the standard scar below the ribs      can be painful afterwards, infusions of pain killers
        and a second scar lower down on the abdomen. The      can be added to this. Alternatively, the anaesthetist
        surgeon’s first priority is always to ensure the      may insert an epidual catheter to administer
        safety of the living donor.                           medication close to the spinal cord to help with
           The kidney is lifted out of the wound and flushed  post-operative pain. This is usually removed on the
        with a cold solution to wash out blood and slow the   second or third day post-operatively.
        metabolism before being carried into the adjacent        A catheter is inserted in the bladder. Tubes are
        operating theatre in which the recipient is waiting.  usually removed, after the first day, and the donor
           The incision(s) is/are then sewn up and the donor  is encouraged to get up and sit in a chair.
        is transferred to the recovery room and,                 A donors stay in hospital is usually between 4-6
        subsequently, the ward. Sometimes a temporary         days. He or she can expect to be out of bed the day
        drain is fitted near the wound. Fluids can be         after the operation and home in less than two
                                                                            weeks. The stitches are removed
                                                                            approximately 10 days post-surgery.
                                                                            The wound may remain sensitive for
                                                                            several weeks.
                                                                               Sometimes a small area of
                                                                            numbness may be noticed on the
                                                                            skin of the abdomen, because small
                                                                            nerves have been cut by the incision
                                                                            at the side. However, the scar should
                                                                            be the only permanent reminder of
                                                                            the donor operation. The donor will
                                                                            usually have to take 4 weeks off
                                                                            from work to recuperate, depending
                                                                            on the individual and his or her
                                                                            occupation.







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