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Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...

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Related Experiment Video

Updated: Jun 22, 2026

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
06:39

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NOTES transvaginal nephrectomy: first human experience.

Jihad H Kaouk1, Wesley M White, Raj K Goel

  • 1Center for Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA. kaoukj@ccf.org

Urology
|July 2, 2009
PubMed
Summary
This summary is machine-generated.

Natural orifice translumenal endoscopic surgery (NOTES) transvaginal nephrectomy is technically feasible for kidney removal. This minimally invasive approach offers a viable alternative with a short hospital stay and low pain scores.

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Area of Science:

  • Minimally Invasive Surgery
  • Urologic Oncology
  • Endoscopic Surgery

Background:

  • Natural orifice translumenal endoscopic surgery (NOTES) represents an advancement in minimally invasive surgical techniques.
  • Transvaginal nephrectomy, a specific application of NOTES, aims to reduce abdominal scarring and postoperative pain.

Observation:

  • A 57-year-old female patient underwent a successful NOTES transvaginal nephrectomy for an atrophic right kidney.
  • The procedure involved transvaginal port placement, kidney mobilization, and renal hilum control using an endovascular stapler.
  • Dense pelvic adhesions required the use of a supplemental umbilical port for optimal visualization and retraction.

Findings:

  • The NOTES transvaginal nephrectomy was completed successfully with no intraoperative complications.
  • Total operative time was 307 minutes, including 183 minutes for adhesiolysis and nephrectomy.
  • The patient experienced a short 23-hour hospitalization and a low postoperative pain score (1/10).

Implications:

  • This case demonstrates the technical feasibility of NOTES transvaginal nephrectomy.
  • Visual guidance and umbilical insufflation are recommended for peritoneal access.
  • Further research is needed to establish patient selection criteria and indications for NOTES in urologic surgery.