Page last updated at 09:04 GMT, Monday, 13 July 2009 10:04 UK

Kidney removed by 'scarless' surgery

By Anna-Marie Lever
Health reporter, BBC News


See how it was done

"After 27 years of pain, this surgery has solved the problem in just a few hours".

Estelle Rolinson is one of the latest patients to undergo pioneering "scarless" surgery.

She has had part of her kidney removed through her belly button, by a technique known as single incision laparoscopic "key-hole" surgery (SILS). Once the belly button is sewn up, only the tiniest scar remains.

"Since I was 12 my life had been a lot of kidney infections, water infections, lots of pain in that area generally, which has meant lots of hospital trips, all across the country, for tests," said Estelle.

Double kidney

It was a visit to Eastbourne District General Hospital, East Sussex, that found the cause of the problem.

'Scarless' surgery
The "single access port" allows instruments through the belly button

"It was our Registrar, who solved the mystery," said Mr Peter Rimington, Estelle's surgeon, a urology consultant.

"After asking for a 64-slice spiral CT scan we discovered a duplex kidney on the right hand side, with the upper part of that kidney draining without the bladder."

A duplex kidney means that part, or all, of a kidney is duplicated. In Estelle's case, the top half of her right kidney.

Each kidney should drain via its own tube, the ureter, into the bladder. Estelle had two of these tubes on one kidney, with only one functionally properly.

The procedure

During the surgery a small 10mm incision was made in the crevice of Estelle's belly button and a "single access port" inserted through which instruments and a small camera were fed.

Her belly was inflated with carbon dioxide to provide manoeuvring room.

Once the extra tube was cut off, it was pulled out and bellybutton stitched up.

"Magic," Mr Rimington said.

Traditionally, the specimen would have had to be removed by making three incisions in the torso as well as the belly button - a process which leaves scars across the abdomen.

Mr Rimington said: "This new technique, because of the smaller wound, also means quicker healing and less pain."

While Estelle says she would have had the surgery if the previous technique was only available, she describes the "scarless" surgery as "icing on the cake".

The future

This technique is being used in hospitals across the UK to remove whole organs - including the spleen and appendix.

In the US it is being used for hysterectomies- removing the uterus through the belly button.

Surgeons there have also removed organs through the body's natural orifices, such as kidneys through the vagina and gallbladder through the mouth.

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