Cancerous Kidney Removed Through Belly Button

On Thursday, February 5, 2009, surgeons at the University of California, San Diego Medical Center removed a patients diseased kidney through one incision hidden in the belly button. No other incisions were used. This groundbreaking procedure is the 15th in a series of single-incision clinical trial surgeries performed by the UC San Diego Center for the Future of Surgery. The successful removal of a kidney containing a seven centimeter tumor, with a single incision, is a pivotal advancement in cancer care, said Ithaar H. Derweesh, MD, associate professor of surgery for the Division of Urology and urologic oncologist at UC San Diego Medical Center and Moores UCSD Cancer Center. This less invasive approach offers patients a shorter recovery time, less need for pain medication, and an improved cosmetic outcome. During a traditional laparoscopic surgery, three to five small abdominal incisions would be made to insert a camera and instruments to remove the kidney. This novel surgery required one incision in the navel. The idea of being able to perform a surgery with fewer incisions and requiring a shorter hospital stay is particularly attractive to cancer patients who may face repeated surgeries, said Santiago Horgan, MD, professor of surgery, and Director of the Center for the Future of Surgery at UC San Diego. We are currently testing these scarless procedures for the treatment of cancer, obesity and other digestive disorders. According to the American Cancer Society, kidney cancer is an expanding cancer, increasing at a rate of two to three percent each year and affecting approximately 55,000 patients in the United States. Risk factors for developing kidney cancer include smoking, obesity and hypertension. Kidney cancer is among the 10 most common cancers in men and women, said Derweesh, an expert in kidney-preserving surgeries and a member of the American Urological Associations Guideline Committee for the treatment of kidney tumors. The combination of kidney cancers being diagnosed at earlier stages and smaller sizes, and the ability perform less invasive surgeries, presents a new horizon of care for these patients. Source: [Link]

SUMMARY: Its amazing how fast surgery procedures are moving with reference to new procedures made possible by new technologies. This was proven by this published article entitled Cancerous Kidney Removed through Belly Button. By using the embryonic orifice as a point of entry, there is less scaring and a shorter recovery time and there are not as many nerves in this area as there are in other areas of the body, so that might suggest a little relief in the pain area with recovery. The procedure is ok for both men and women and requires a surgical team specially trained on the surgical instruments used.

The team surgeons at the University of California, San Diego Medical Center has removed a kidney from a patient diagnosed with kidney cancer, through a single opening. This is the first operation of this type carried out in San Diego, California and one of very few performed throughout the world. Recovery time is reduced by half and the surgical results are far better than those of conventional laparoscopy. The operation was carried out with material specially designed to be able to work from the navel, access that requires control and precision.

The single-port transumbilical nephrectomy, the technical name for this operation, was carried out using a single troca. This laparoscopic instrument requires considerable control and precision to be used correctly, as the surgeon has to use 3 instruments through a single point in order to manipulate the organ remotely and extract it once it has been entrapped inside the body. Accessing the kidney via this route means no visible marks are left as the minimal incision made by the surgeons is hidden by the natural folds of the umbilical scar. Nevertheless, as with laparoscopic surger, the transumbilical route is not completely risk-free and must always be performed by an experienced team of surgeons who are permanently trained in the use of the instruments.

After the successful removal of the cancerous kidney, the patient may required to stay in the hospital for three days and after that, the patient may go home. Thus, shorter stay in the hospital was promoted and lesser pain was felt by the patient because the procedure only requires one, shorter incision. REACTION: The kidneys are organs with several important functions. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid-base balance, and regulation of blood pressure. They serve the body as a natural filter of the blood, and remove wastes which are diverted to the urinary bladder. Basically, the tubes inside filter and clean your blood, taking out waste products and making urine. When a person was predisposed to the following risk factors such as smoking, having certain genetic conditions and misusing pain medicines for a long time, kidney cancer may develop. Kidney cancer forms in the lining of tiny tubes inside your kidneys. It happens most often in people over 40. Often, kidney cancer doesn't have early symptoms. Treatment depends on the age and overall health of the patient, and how advanced the cancer is. It might include surgery, radiation, chemotherapy or biologic therapy. Biologic therapy boosts your body's own ability to fight cancer.

Upon searching a journal about surgical ward, what caught my eyes and interest is this article. The title goes Cancerous Kidney Removed through Belly Button. What comes first in my mind is how would it be possible performing a surgical removal of the cancerous kidney through belly button. That question provokes me in reading the article.

After reading the article, I was filled with amazement and satisfaction because I learned that it was really possible that cancerous kidney can be removed using one small incision in the navel of the patient. This newly invented surgical procedure is a pivotal advancement in cancer care and it serves a hallmark in improving patient care. It is because this new surgery only requires one small incision that is hidden by the belly button and it uses less invasive approach which offers patients shorter recovery time, less need for pain medication, and an improved cosmetic outcome. This newly invented surgical procedure was really exciting and interesting because from this innovation, inspired surgeons may use this to innovate others new surgical procedures in treating other diseases. I have read on other articles that surgeons used this newly invented surgical procedure in removing a healthy kidney from the kidney donor which will be further used for kidney transplant. There were also reports that some surgeons were testing these scarless procedures for the treatment obesity and other digestive disorders. RELATED NURSING THEORIES Leavell and Clarks Three Levels of Prevention The model focuses on the clients primary, secondary and tertiary prevention. In the primary prevention, this is done to encourage optimal health and to increase the mothers resistance to illness. It seeks to prevent a disease or condition at a prepathologic state and to stop something from happening. It includes health promotion activities like educating people to eat a balanced diet and maintain a healthy lifestyle all of the times. It also involves illness prevention activities like screening and preventive education for people. Secondary prevention seeks to identify specific illnesses or conditions at an early stage with prompt intervention to prevent or limit disability for the early diagnosis, detection and screening. This include diagnosis of meningiomas using advanced molecular technology represents a major breakthrough in early diagnosis and management of the disease. Tertiary prevention is to support the persons achievement of successful adaptation to known risks, optimal reconstitution, and establishment of highlevel wellness. It involves continuous adherence to the therapeutic regimen and avoid things that could lead to periods of remission and exacerbation. In the case of cancer

patients, these three levels of prevention were very helpful in avoiding further complications and in promoting relief from their sufferings.

Comfort Theory by Katharine Kolcaba Kolcaba described comfort as existing in 3 forms: relief, ease, and transcendence. Also, Kolcaba described 4 contexts in which patient comfort can occur: physical, psychospiritual, environmental, and sociocultural. If specific comfort needs of a patient are met, for example, the relief of postoperative pain by administering prescribed analgesia, the individual experiences comfort in the relief sense. If the patient is in a comfortable state of contentment, the person experiences comfort in the ease sense, for example, how one might feel after having issues that are causing anxiety addressed. Lastly, transcendence is described as the state of comfort in which patients are able to rise above their challenges. In the case of cancer patients, comfort theory was very helpful in promoting comfort and relief from their sufferings.

Steven and Johnstons Gate Control Theory of Pain Stevens and Johnston cited numerous theories for pain, including specificity, intensity, pattern-peripheral, central summation and sensory-interaction and effect. The gate control theory of pain is the most current and comprehensive theory with regard to neonates. Even though the processing of pain is a complex phenomenon, the gate control theory states that the human processing system is flexible and plastic. Other reactions to stimuli have the ability to override the original stimuli that would have caused a sensation of pain. The ultimate perception of pain is dependent on the complex modulation of neural impulses in ascending pathways in relation to the activation of descending inhibitory systems. Cancer patients usually suffer from intense pain when there is an exacerbation of the disease, thus, surgeons invented a surgical procedure that may help these cancer patients to treat their condition in a less invasive way for them not to suffer

for intense post-operative pain, rather they will feel lesser pain after the surgical procedure.