Robotic Autotransplantation and Management of Post-transplant Anastomotic Strictures: the Future Is Here
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Purpose of Review
We set out to review the current published experience with robotic autotransplantation. Although the experience to date is limited, this surgery appears to be safe and technically feasible. We also examined the use of the robotic surgical platform for the management of post-transplant uretero-vesical anastomotic strictures.
To date, only four reported cases of robotic autotransplantation have been described with two being performed completely intra-corporeally. An intra-corporeal approach is feasible for benign conditions, while malignant masses should be inspected and dissected extra-corporeally. Ureteric strictures after renal transplantation are common. To date, the experience with robotic surgical management is limited but has also been shown to be safe and feasible.
While robotic autotransplantation is still in its infancy, it is feasible and appears to be safe. Renal allograft function and surgical outcomes are favorable and provide patients the option to have a historically more morbid surgery performed with a minimally invasive approach.
KeywordsRobotic surgery Autotransplantation Robotic renal transplantation
Compliance with Ethical Standards
Conflict of Interest
Tad Kroczak, Luke F. Reynolds, and Michael Ordon each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 8.•• Gordon ZN, Angell J, Abaza R: Completely intracorporeal robotic autotransplantation. J Urol. 2014; 192(5): 1516–22. The first published report of a completely intracorporeal robotic autotransplantation. This landmark report demonstrated the feasibility and safety of robotic assisted ReATx. Google Scholar
- 9.• Lee JY, Alzahrani T, Ordon M: Intra-corporeal robotic renal auto-transplantation. Can Urol Assoc J. 2015; 9(9–10): E748–9. The first Canadian and second published report of completely intracorporeal robotic autotransplantation. The described technique was modified to minimize renal ischemia previously encountered by Abaza and colleagues. This was accomplished by performing the pelvic vessel dissection prior to the nephrectomy. Google Scholar
- 16.D.A. Shoskes, D. Hanbury, Cranston PJ, Morris Urological complications in 1,000 consecutive renal transplant recipients J Urol, 153 (1995), pp. 18–21.Google Scholar
- 25.J. Hauser, J. Schwartz, S. Tran, C. Iselin. Robotic assisted uretero-ureteral (receiver-donor) anastomosis. Eur Urol Suppl, 11 (2012), p. eV42.Google Scholar