Abstract
Introduction
Kidney transplantation (KT) is the preferred treatment for patients with end-stage renal disease (ESRD). To reduce the morbidity of the open surgery, a robotic-assisted approach has been recently introduced. Our aim is to evaluate surgical and functional results on 17 cases of robotic-assisted kidney transplantation (RAKT) performed at the same institution.
Materials and methods
From July 2015 to June 2016, we performed 17 cases of RAKT from living donors in pre-emptive patients, who underwent laparoscopic nephrectomy. A prospective pilot study was made at Fundació Puigvert (Barcelona), evaluating functional and surgical outcomes. In this series, we considered the functional results, surgical outcomes and complications rates.
Results
Seventeen patients successfully underwent RAKT, in particular surgical console time was 181 min (150–200) with vascular suture time 42 min (32–48), and estimated blood loss <70 ml. Overall ischemia time was 98.9 min (84–140). No patient was converted to open transplantation. No major surgical intra-operative complications were observed. The mean post-operative serum creatinine level 160 μmol/L (81–479). We reported a case of delayed graft function (DGF), one case of graft arterial thrombosis and one case of intraperitoneal hematoma. No anastomosis revision and wounds infections occurred.
Conclusion
RAKT with regional hypothermia appears to be a safe surgical procedure in a properly selected group of patients. The potential advantages of RAKT are related to the quality of the vascular anastomosis, the possible lower complication rate and the shorter recovery of the recipients.
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Abbreviations
- BMI:
-
Body mass index
- dVSS® :
-
Da Vinci surgical system®
- DGF:
-
Delayed graft function
- ESRD:
-
End-stage renal disease
- GFR:
-
Glomerular filtration rate
- KT:
-
Kidney transplantation
- PKD:
-
Polycystic kidney disease
- POD:
-
Post-operative day
- RAKT:
-
Robotic-assisted kidney transplantation
- VAS:
-
Visual analog scale
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Authors’ contribution
A Breda: Project development, data analysis, manuscript writing. A Territo: Data collection, data analysis, manuscript writing. L Gausa: Project development. M Guazzieri: Data collection. A Guttilla: Data analysis, manuscript writing. O Rodriguez-Faba: Data collection. J Caffaratti: Data collection. J Ponce de León: Data collection. L Guirado: Data collection, data analysis. H Villavicencio: Manuscript editing.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Breda, A., Territo, A., Gausa, L. et al. Robotic kidney transplantation: one year after the beginning. World J Urol 35, 1507–1515 (2017). https://doi.org/10.1007/s00345-017-2006-8
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DOI: https://doi.org/10.1007/s00345-017-2006-8