Surgeon Removes Kidney Through Patient’s Navel

One of UHealth’s experts at minimally invasive surgery has performed a groundbreaking operation. Raymond J. Leveillee, M.D., FRCS-G, chief of the Division of Endourology, Laparoscopy and Minimally Invasive Surgery, recently removed a patient’s kidney through her navel, leaving no visible scar.

It marked the first time a South Florida surgeon performed a single-incision nephrectomy using the TransEnterix SPIDERĀ® Surgical System. Leveillee, a professor of urology, is only the second surgeon in the world who has done this procedure.

The patient in this case was 26-year-old Joanna Armas. A pharmacist in Miami, Armas suffered an ureteropelvic junction obstruction, a congenital blockage in the area connecting her kidney’s renal pelvis with its ureter, the tube that moves urine to the bladder. Over time, the blockage permanently damaged the kidney and was causing her great discomfort.

While traditional laparoscopic surgery would have required several incisions, using the SPIDER system, Leveillee was able to perform the operation entirely through an inch-long incision in Armas’s navel, leaving no visible scar.

Leveillee has used other single-incision surgical systems and says they sometimes created a more crowded operating field. Using the SPIDER system, Leveillee made a small incision in the navel, inserted the device into the abdomen and then opened it like an umbrella. The expansion allowed him to operate at the same angles as traditional laparoscopic surgery, and provided flexible instruments that enhanced his access and dexterity. When finished, Leveillee retracted the SPIDER system and removed it through the same incision.

“My initial response to single-incision surgery was that it was counter-intuitive to take angles and instruments – the advantages of traditional laparoscopic surgery – and put them into one small hole,” said Leveillee. “The SPIDER system represents a real progression in the evolution of minimally invasive surgery. It gives me the dexterity, maneuverability and the clear field I want as a surgeon, while maintaining the benefits of a smaller entry for the patient.”

Armas said that she felt immediately better afterward with hardly any discomfort at her surgical site – an experience made all the more amazing considering that her kidney was about twice the normal size.

“My belly button is healing quite well,” she said. “You cannot even tell I had anything done, which is just crazy. My life is so much better now; I’m not in any pain, I can function, I can work. I am extremely grateful for Dr. Leveillee and his team – because of them, I have recovered my life.”

Leveillee has plans to continue to perform more surgeries with the SPIDER. There are several refined generations of the device in the works to improve its ease of use and cost.

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