Cecil notes that kidney removal normally takes a surgical team, lots of bulky equipment and 5 hours.
This might be the case when things are done by the book - although I can’t understand how this would be 5 hours’ worth of surgery - I suspect it is the time from premedication to recovery.
Removing a kidney is theoretically not that hard a job - there is one artery, one vein and one ureter to ligate. In dogs the biggest issue would be getting surgical access (assuming you’re trying to do it through a midline incision, which is standard for exploratory surgery; a flank incision would probably make things easier). Humans are quite a bit flatter (assuming no obesity) so I would have thought it would be fairly easy. I reckon it would take about 1-2h of surgical time to properly remove a kidney from a big dog, with most of that being closing the wound afterwards (in case it isn’t obvious, I haven’t actually removed a kidney pre-mortem, so this is an extrapolation of other abdominal surgeries I’ve done and how easy it is to remove post-mortem).
If you change the technique to sacrifice safety for speed*:
hand sized flank incision
put hand into abdomen, find kidney by palpation. Bluntly dissect the perirenal fat with fingers.
somehow (ligation clips, ligatures or (for those who don’t have access to surgical equipment) multiple wraps of sterile wire) tie off the three tubes (which conveniently leave the kidney at the same consistent place). This would be the trickiest part. You can get an instrument called an ecraseur (from ebay) which would make things easier.
pull or cut out the kidney.
staple the muscle skin back together.
I reckon 5-30 mins depending on your level of competence and confidence. Main immediate downside is you can’t see if there’s any bleeding, so if your vessel closure is inadequate the patient has a problem. You might also get arteriovenous or arterioureteric fistulation later on if the walls between the vessels break down, although this is more likely to become some other surgeon’s problem.
Although vets in the UK normally have one assistant (training levels vary) to fetch instruments and monitor the anaesthetic, you could get away without this most of the time. Although we normally use inhalational anaesthetics for big ops you could trickle barbiturate or proprofol in through an IV line (if you keep the syringe sterile you don’t even need to break sterility).
Properly sterile operating theatres are hard to come by - for instance, as soon as you add large monitoring equipment you stand a good chance of having a vented box which collects dust. Fortunately most of us have an immune system which copes with minor contaminants (such as someone breathing onto an opsite) - its rare (in my experience) to get significant infections in veterinary surgery unless a gut wound breaks down.
My point (I’m sure I had a point)? Ah yes. The precautions they take in a big hospital when they really don’t want to get sued for a bit of a scar and the precautions you’d need to take to not kill most of your patients are worlds apart.
*For the record, I’ve never heard of kidneys being removed this way; it certainly isn’t the way I’d do it. However I believe that using an ecraseur via an incision made through the vaginal wall is a recognised way of removing an ovary from a horse - the ovaries are in about the same place, although more mobile.
I suppose if you’re stealing a kidney and not just letting the involuntary donor die you’d go through enough trouble to give the guy a fighting chance. I assume the point of not letting the guy die is to avoid a charge of murder, although that seems pointless since organ theft would draw a hefty sentence anyway.
To clarify: I reckon the survival rate of even the fastest technique I described would be well over 50% if done by a surgeon of a year or two’s experience - that is without the “call 999” note. At the very least that should drop it from murder 1 to murder 2 (manslaughter in the UK) - quite a considerable drop in prison sentence (in the UK murder gets automatic life sentence (normally with parole after a few decades) and manslaughter is normally 2-10 years (anything from nothing to life)
I’m not sure the reason would be just to avoid the murder charge - I think there is quite an ethical difference between stealing something that someone most likely won’t miss (this does assume you’re just taking one) and killing them outright. If you’re taking both kidneys then while they might not die (with expensive, invasive lifelong treatment or a transplant) they might wish they had.
This is a huge global operation - and not just for Kidneys … Corneas are much sought after as they are very profitable and very easy to transport without required blood type and tissue matching. I am looking into the disappearance of homeless people in Eastern Europe and … get this … a link to the Church which seems to be heavily involved.
Wealthy recipients in the USA abound and black market operations in top eye clinics … there is a high number concentrated in Santa Barbara (why so many)… close proximity to Hollywood. There are also a huge number in NYC.
DNA matching and traceability of donors should cause quite a stir - especially if there is a famous actor or few involved.
Looking into this for a BBC Panorama and Local TV Production Company Documentary.
The key trigger was why this particular Church (founded in the USA) logs Homeless people in their computer in a database at their very upmarket soup kitchen… when I asked further there was alarm bells all the way to the priest … who has a rather interesting surname and likely of German (think WWII) descendant … the plot thickens …
Okay, I’m going to first stat that Psychology Today has never been a source of science or news that I trust. It maybe something coloring my perception.
Here’s the whole issue with the stealing organ thing: If you’re psychopathic enough to knock someone out, and steal their organs, why would you even bother with keeping the person alive? That victim is prime evidence and could lead police right to you. Plus, there’s a lot of expense and time to keep the victim alive. Heck, 50 pounds of ice will run you around $20 right there. Plus, you’ll need sutures, better medical training, plasma, and a sterile operating theater.
And, for what? If you do get caught, it’s not like they’ll give you time off because you only stole one kidney. Very likely, you’ll still be charged with attempted murder, and if the victim does end up dying, first degree murder.
If someone is evil enough to steal vital organs, they will have no qualms whether the victim lives or dies.
Welcome to the Straight Dope Message Boards, Dapper007, glad to have you here (and I like your screen name.)
Since there was already a thread on this topic, I’ve merged your post into that thread. It’s helpful to readers if all posts on the same topic are together. Hope you don’t mind, and, as I say, welcome!
Excerpt: “Chhay, 18, sold his kidney for $3,000 in an illicit deal that saw him whisked from a rickety one-room house on the outskirts of the Cambodian capital Phnom Penh to a gleaming hospital in the medical tourism hub of neighbouring Thailand.”