Complete robotic-assisted kidney transplantation: A safe alternative to open approach
Seung Duk Lee1, Amit Sharma1, Aamir Khan1, Adrian Cotterell1, David Bruno1, Vinay Kumaran1, Marlon Levy1, Chandra Bhati1.
1Hume Lee Transplant Center, VCU Health, Richmond, VA, United States
Background: robotic-assisted kidney transplantation (RAKT) is a relatively new surgical technique and remains in its infancy. Few transplant centers are currently performing kidney transplants using this approach. Most centers perform RAKT with hand assistance. We report out initial experience with the full robotic technique.
Methods: We retrospectively analyzed the RAKTs performed from Jun 2018 to Nov 2019. Demographic information of the donors, recipients, and technical aspects of the surgery and complications were recorded and analyzed. CUSUM analysis was performed to evaluate the learning curve and the number of cases required to reach proficiency.
Results: We performed a total of 23 non-hand assisted RAKTs with a median age of 34 years (24-59). Demographic profile and operative details are described in table 1. All kidneys were implanted on the right side and eighteen of them were placed into the retroperitoneal space. None of our patients had delayed graft function or any surgical site infections. Significant improvements were noted with both WIT and total anastomosis after the 13th case. Competence was achieved in the venous anastomosis after the 13th case and in the arterial anastomosis after the 8th case. One year patient and graft survival was 100%.
Conclusion: our early results suggest that non-hand assisted RAKT is a technically feasible procedure and appears to be a safe surgical alternative to the standard open approach with excellent outcomes.
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