Pourriez-vous croire qu’il est possible de faire une greffe rénale en faisant passer l’organe par le vagin ?!
Eh bien oui. Il est désormais possible d’appliquer cette technique paraissant extravagante, à l’aide d’un robot : l’extraction et la transplantation du rein se font par voie vaginal. Les patientes ne courent aucun risque. Pas de douleurs. Et pas de cicatrices…
La transplantation par voie vaginale a été effectivement réalisée entre une patiente souffrant d’une insuffisance rénale et sa sœur donneuse. L’expérience a été faite par un chirurgien urologue et par un spécialiste en chirurgie urologique robotique.
Présentation de la transplantation robotisée
Les chirurgiens pratiquent des incisions très discrètes sur chacune des patientes. Les petites plaies se font à l’intérieur du vagin et ce, pour déplacer le rein de la cavité vaginale vers la cavité abdominale.
Ils enlèvent, ensuite, le rein et le mettent dans un sac. Une couche de gel couvre la membrane extérieure de ce sac. L’objectif est de faire glisser la poche facilement à travers le vagin. Le geste chirurgical se déroule à l’intérieur de l’organisme. Des images sur ordinateurs permettent aux urologues de contrôler toutes les étapes du procédé. Les gestes pratiqués au cours de cette opération n’induisent pas de douleurs. Une heure après l’intervention, le rein transplanté retrouve son fonctionnement normal.
Cette technique s’adresse aux femmes. S’agissant de la catégorie masculine, il est possible de transplanter un rein chez un homme, à l’aide d’une chirurgie assistée par robot. Dans ce cas, l’incision se situe au niveau de l’aine.
Le robot chirurgical a été utilisé depuis de nombreuses années aux États-Unis. L’idée d’introduire un rein à travers le vagin provenait des chirurgiens indiens. Mais, la technique qu’ils proposaient nécessitait toujours la réalisation d’une importante incision au niveau de l’abdomen.
Par contre, l’opération que je viens de décrire combine l’usage d’un robot et la technique de l’introduction du rein à travers l’orifice vaginal et ce, sans faire une large cicatrice. En outre, cette combinaison permet de limiter les douleurs post-opératoires. L’usage des traitements antalgiques n’est plus nécessaire. La patiente, donneuse, rentre chez elle après 48 heures. La patiente receveuse quitte l’hôpital seulement après 4 jours d’hospitalisation.
Cette découverte répond aux attentes des patientes :
- la transplantation robotisée n’est pas douloureuse
- la récupération est facile
- On ne risque pas d’avoir une cicatrice apparente et très inesthétique.
Suivre l’actualité de la recherche médicale nous réconforte qu’on pense à nos proches malades et aux maladies qu’on risque d’attraper à la vieillesse. J’espère que cette intervention sera bientôt démocratisée dans plusieurs pays du monde.
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