Minimal skin incision in living kidney transplantation.

Usually, the transplanted kidney is placed into the right retroperitoneal iliac fossa through a right abdominal surgical skin incision. The skin incision may be oblique or inverted J-shaped known as the "hockey stick." The oblique or curvilinear incision, parallel to the inguinal ligament, known as the "pelvic Gibson incision," is also extended medially to the midline, just above the pubis. The most common incision for kidney transplantation in our center is a paramedian incision, which is parallel to rectus abdominis muscle and extends medially to the midline, just above the pubis symphysis ("hockey stick"). Nowadays, minimally invasive surgery is popular in various field of surgery; the number of patients who are concerned about cosmetic effects are increasing. We make the skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis in five young unmarried women whose body mass index was >25 and there were no anatomic variations. The lower transverse abdominal skin incision showed more favorable cosmetic results and there was no difference in postoperative factors, including renal function, compared with other routine renal transplant patients.