Transplant procedure helping local family
Dr. Kusum Tom with the Da Vinci surgical robot at Allegheny General Hospital in Pittsburgh. (Submitted photo)
In July, Allegheny General Hospital in Pittsburgh unveiled a new minimally-invasive robotically-assisted transplant system that has already seen local residents receiving a much-needed kidney.
Everett Sechler of Confluence underwent surgery to receive a kidney from his neighbor Sondra Waite on Tuesday, Oct. 8 using the new system. By that weekend, both were home and recovering.
"I was surprised by how easy it was," Waite said. "When I heard that he needed the transplant I wanted to help any way I could. It was the Christian thing to do."
Chris Sechler, Everett Sechler's wife, said the donation was a blessing. "She's like family," she said.
Dr. Kusum Tom — who performed the surgery — said that the decrease in recovery time is largely due to advances in technology that reduce the surgery's pain and trauma by minimizing the number and size of the incisions needed to both remove and implant the kidney.
"I think this technology is going to be applied to a lot more specialties," she said. For Tom — who came to Allegheny General Hospital in 2008 — the da Vinci Robotic Surgical System is a wonder.
The robot allows her to sit several feet away from the patient and immerse herself in a high-resolution, three-dimensional view of the patient's insides. The da Vinci camera and robotic arm instruments are inserted into the patient through three half-inch incisions. A total of five incisions are needed during the operation, Tom said.
Using hand controls and foot pedals to manipulate the robotic arms, the fully intact kidney is stapled off from the blood supply on one side and removed through a small, 3-inch lower abdominal incision.
"The high-def camera inside the patient is like looking into binoculars. Remarkable clarity and detail," she said.
The process differs from conventional laparoscopic surgery because the new system eliminates hand-held instruments while integrating the monitor display. The robotic tools reduce the operator's movements, eliminating tiny tremors while allowing the surgeon to keep their eyes constantly on the display and patient.
"It's a lot of training, but this system is a significant advancement," Tom said.
The system is the world's most advanced surgical robot and was originally developed by NASA for operating remotely on astronauts in space and used by the Department of Defense to operate on soldiers in the battlefield, according to a hospital press release.
Procedures for implanting the kidney have also significantly changed in the last few decades, Tom said. Unless the recipient's kidneys are diseased or damaged, they are usually left in place while the new kidney is placed within the abdominal cavity and attached to a carefully-chosen blood vessel near the bladder.
The doctor has performed six of the 4-hour surgeries since the hospital purchased the system. "Every time we get a little faster," she said.
In ideal situations, the donor can return home the day after the surgery and the recipient within four days, Tom said. "We went to this from an operation that put you out of commission and on your back in the hospital for more than week," she said.
The India-born surgeon knew she wanted to be a doctor from the time she was 3 years-old. Growing up in Queens, N.Y., her parents told her to reach for the stars, and she did.
"I wanted to do transplants because it was my calling. You also get to work in a field where you get to see most of your patients get better," Tom said. "I don't think a lot of people knows what it means to others when you become an organ donor."
Waite — who moved to Somerset County from Dallas nine years ago — now understands that gift. "I never dreamed I would become a kidney donor. I thought it would be easier than having a baby, and it was."
The entire process took approximately four months. Matching her kidney to Sechler required several blood tests, a urine test, MRI and a CAT scan to determine the location of her kidneys and the size of the blood vessels attached to them.
She also had to appear before a transplant board for counseling about the operation and candidate review, Waite said.
Donors generally completely recover within one month and are rarely limited in diet or lifestyle following the donation, Tom said. Advances in antibiotics and pharmaceuticals have also allowed the donated kidney to last much longer in the new host, Tom said. Some transplants last as long as 15 years, which is more than double the time early donations were expected to function well, she said. "I can't emphasis enough what a wonderful gift organ donation is," she said.
Dr. Ngoc Thai, director of the hospital's Center for Abdominal Transplantation, said in a release that living donation transplants are generally more successful than using a kidney from a dead donor.
Living donors means the organ preservation time is shorter and the tissue match is usually better between the donor and the recipient.
"Hopefully, as the option of robotic minimally invasive surgery becomes more readily available to potential donors, it will encourage more people to consider donation," he said.
The United Network for Organ Sharing (UNOS) estimates that approximately 70,000 people are currently on the waiting list for kidney transplantation in the United States.
For Waite, becoming a donor has transformed her. "If Everett needed another kidney and I had one, I'd give in a second," she said.
For more information about kidney and other organ donation visit www.unos.org online. For more information about Allegheny General Hospital visit www.wpahs.org/locations/allegheny-general-hospital online.