經陰道自然孔道內視鏡手術輔助之腎臟活體捐贈：病例討論
郭萌享，陳志碩，林威宇，何東儒，黃雲慶，林健煇，黃國財，邱國雄
嘉義長庚醫院 外科部 泌尿外科
Transvaginal natural orifice transluminal endoscopic surgery-assisted living donor nephrectomy: Cases Discussion
Meng-Hsiang Kuo, Chih-Shou Chen, Wei-Yu Lin, Dong-Ru Ho, Yun-Chin Huang,
Pey-Jium Chang, Jian-Hui Lin, Kuo-Tsai Huang, Kuo-Hsiung Chiu
Division of Urology, Department of Surgery Chang Gung Memorial Hospital, Chia-Yi, Taiwan
Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the abdominal cavity. Profession Alcaraz had presented NOTES to perform transvaginal NOTES-assisted laparoscopic nephrectomy in living donor since 2009. We presented our first case of NOTES-assisted living donor nephrectomy (NOTES-aLDN).
The 58 year-old female kidney donor was multi-partum mother. She received NOTES-aLDN to donate kidney to her daughter. The warm ischemic time (WIT) was similar in this patient compared without our previous laparoscopic counterparts, without consequences for graft functioning. Operation time was four hours, which is also similar to our previous donor nephrectomy surgeries. No postoperative bleeding was noted. Donor kidney functioned well. Recipient discharged in two weeks.
Transvaginal NOTES-aLDN appears to be a feasible surgical technique. The WIT may be similar in donor with previous transvaginal delivery. No effect on graft function after the short follow-up