Fargo, N.D. - In a replay
of a live internet webcast first seen on Monday, October 27,
2003, MeritCare presents a live,
webcast of a hand-assisted laparoscopic donor nephrectomy (i.e.
minimally invasive removal of a kidney for transplant.) The surgery
took place at MeritCare Health System, Fargo, N.D. and is available
for viewing by the public anywhere in the world .
MeritCare is one of a handful of healthcare institutions in
the nation to broadcast live, surgical webcasts and the only
hospital in North Dakota to offer both kidney and pancreas
The surgery was performed by a MeritCare surgical team
consisting of Bhargav Mistry, M.D., transplant surgeon, and
Timothy Monson, M.D., general and laparoscopic surgeon. Dr.
Mistry and Dr. Monson were available to field questions
from the public and healthcare professionals from around the
world submitted via e-mail during the live webcast.
- The surgical procedure: The hand-assisted
laparoscopic donor nephrectomy is a less invasive technique
for removing a kidney from a living donor for transplantation.
The surgery involves the insertion of a laparoscope (surgical
telescope) through three to five small incisions in the donor’s
abdomen. Using precision instruments that are inserted into
the small openings, the surgeon prepares the donor’s
kidney for removal while simultaneously observing a magnified
image on a TV monitor. When the kidney is ready for removal,
the transplant surgeon gently removes the kidney through
a small opening. The kidney is then prepared for transplantation
into the recipient.
- The benefits: This technique for kidney
removal is a vast improvement on the traditional method of
open nephrectomy, which requires a longer incision and the
removal of a rib. The laparoscopic technique requires several
smaller incisions to remove the kidney, allowing minimal
disruption to the donor’s abdominal wall. This results
in less pain and scarring, a shorter hospital stay and a
quicker recovery time for the donor.
MeritCare’s Transplant Program: MeritCare
Health System has provided kidney transplants since 1989 with
a total of 325 transplants having taken place in the past 14
years. MeritCare Transplant Services currently provides both
kidney and pancreas transplants. Transplant surgeon Dr. Bhargav
Mistry has performed over 140 transplants since he joined MeritCare
in the fall of 2000. The first laparoscopic donor nephrectomy
was performed at MeritCare in February of 2002 by Dr. Monson
and Dr. Mistry. Twenty-six additional laparoscopic nephrectomies
have taken place since that time.
Donor eligibility for laparoscopic nephrectomy: In
order to be eligible for laparoscopic nephrectomy, the donor
must first match with the recipient and be healthy enough
to donate a kidney. Many factors are considered for one to
be eligible for the laparoscopic approach, one being body
size. Most patients are eligible for this type of surgery.
The need for organ donation: The current
need for organ donation is great, with over 55,000 people
on the national waiting list for a kidney. In our region,
1,200 people are waiting for a donor kidney. Most kidneys
transplanted in the U.S. are cadaveric, which means they
are removed from a person who has recently died. With kidney
disease and kidney failure on the rise, the number of cadaveric
organs that become available each year tends to remain relatively
constant, making waiting lists longer and increasing the
number of people who die waiting for a cadaveric kidney to
become available. Living donor kidneys offer one way of bypassing
the long waiting list. People who donate a kidney do not
experience any ill effects aside from having surgery and
often recover quickly.
MeritCare Health Sytem is a not-for-profit, integrated
hospital and clinic system headquarters in Fargo, N.D. Founded
in the early 1900s as St. Luke’s Hospital and Fargo
Clinic, today it is one of the top 100 integrated healthcare
networks in the nation as cited y Modern Healthcare magazine.
MeritCare is comprised of a 583-bed hospital in two locations,
361 physicians, 99 physician assistants and nurse practitioners
and a network of 33 clinics in eastern North Dakota and northwestern
The webcast uses Realplayer to display both video and
synchronized slides in side by side windows. Viewers can download
a free copy of the player here.
It is not necessary to purchase any of Real's premium players or subscription
plans. The free basic player is all that is required to view the surgery.