Two sisters have made medical history by undergoing a kidney transplant through their vaginas using robotic surgery. Valerie Perez, 44, gave one of her kidneys to her 43-year old sister Beatrice Perez on July 9, with both of them in the operating theatre at the same time. The procedure was a world first because, using robotics, the kidney was both removed and transplanted through the vagina rather than via an incision, the standard method. The donated organ was immediately implanted into Beatrice after it had been removed from her sister. The procedure at the University Hospital Centre in Toulouse was executed 'in a single go, exclusively with robots,' the lead surgeon, Frederico Sallustro, told AFP. 'The two sisters are doing well,' said Sallustro, who was assisted in the operation by medical robotics expert Nicolas Doumerc. He added that Valerie returned home the day after the surgery, while her sister stayed on in hospital for another three days. Kidney transplants thorough the vagina are not new, however. In February 2009, surgeons at Johns Hopkins Medicine in Baltimore successfully removed a healthy donor kidney through a small incision in the back of the donor’s vagina. A benefit of this method is that patients avoid a 5-6 inch incision in their abdomen - and surgeons say removing the kidney through 'a natural orifice' speeds up recovery . First, an incision is made in the back wall of the vagina. Surgical instruments are then inserted and used to dissect upwards toward the kidney, which is located midway up the back. Dissecting effectively means opening up layers of tissue to get to the kidney. Once the kidney is reached, surgeons identify the blood vessels supplying it with blood. They then clip the vessels so they do not bleed, and cut them free from the kidney. Methods of removal vary, but generally involve some kind of 'net' to capture the now detached kidney, before it is pulled out through the vaginal incision. The average kidney is 4-5 inches long and about the size of a medium-sized potato.
About 100 people - notably in India, the United States and France - have benefited from robotic kidney transplants in the last couple of years, according to the hospital. Sallustro and Doumerc first combined this high-tech method with a transplant to the recipient via the vagina in May. The donor in that case, however, was a man. With the sisters, the surgical team decided to go a step further by completing both parts of the procedure - removal and insertion - one immediately after the other. 'I have been dreaming of doing this operation for the last three years,' Sallustro said, describing it as a 'major step forward.'
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