How is the donor surgery performed?
Typically, transplant centers perform the surgery (called a nephrectomy) using a laparoscopic procedure—a minimally invasive technique that, over the past two decades, has dramatically impacted the donor experience. Traditionally, kidney donation was an open, considerably more invasive procedure that presented greater risk of post-surgical complications. The laparoscopic technique makes the surgeon’s task easier, but the primary benefit is to the donor because the incisions are smaller, there is less discomfort, hospital stays and recovery time are much shorter, and employed donors can return to work much sooner. Whereas the open method required an 8- to 12-inch incision across the donor’s side, the laparoscopic method requires only 3 small holes (about the size of a pencil eraser) and one 3- to 4-inch incision just below the "bikini line."
The procedure is performed under general anesthesia so that the donor does not feel any pain. A miniature camera is inserted into one of the small holes; this gives the surgeon a view of the kidney and other organs as he or she manipulates surgical instruments through the remaining two holes. Once the kidney—which is about the size of a small fist—is detached, it is removed in a matter of seconds through the small incision. The incisions are closed with stitches that absorb on their own, so there is no need to remove them later. Depending on the specifics, laparoscopic surgery takes anywhere from 2–4 hours.
Donors are ususally discharged on the 2nd or 3rd day after surgery. Typically, donors can return to work in 2 weeks instead of the 4–6 weeks required by the non-laparoscopic procedure.6
The laparoscopic procedure is the preferred and most commonly used method of surgery. Though it is rare, occasionally an irregularity in a donor’s anatomical structure or a history of multiple abdominal surgeries prohibits the use of a laparoscopic procedure, and an open procedure is necessary.