Renal transplantation through a modified non-muscle-cutting Pfannenstiel incision

To assess the feasibility of performing a renal transplant operation through a modified non-muscle-cutting Pfannenstiel incision (MFI).

Renal transplantation with MFI was performed in 20 men with a body mass index (BMI) of less than 25 and five women with a BMI of less than 27. The parameters assessed were incision length, operative time, postoperative pain score by visual analogue score, wound complication, graft-related complications, eGFR at 3 months, and surgical scar satisfaction score. The results were compared with a BMI-matched cohort of patients who had a conventional hockey stick incision. Statistical analyses were done by Chi-square test and Student's t test.

There was a significant decrease in mean bed preparation time, mean time for closure, and mean incision length in patients with MFI. In MFI group, the mean surgical satisfaction score was significantly more. There was no significant difference between the groups on all other aspects.

In the era of minimally invasive surgery, MFI technique could challenge the role of laparoscopic and robotic surgery in renal transplantation. Our study shows that the technique is successful in carefully selected patients with low BMI.