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World Journal of Urology

, Volume 35, Issue 10, pp 1507–1515 | Cite as

Robotic kidney transplantation: one year after the beginning

  • Alberto BredaEmail author
  • Angelo Territo
  • Lluis Gausa
  • Oscar Rodríguez-Faba
  • Jorge Caffaratti
  • Javier Ponce de León
  • Lluis Guirado
  • Carme Facundo
  • Marco Guazzieri
  • Andrea Guttilla
  • Humberto Villavicencio
Original Article

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.

Keywords

Kidney transplantation Regional hypothermia Robot-assisted kidney transplantation Robotic surgery Vascular anastomosis 

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

Notes

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.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights

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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Alberto Breda
    • 1
    Email author
  • Angelo Territo
    • 1
  • Lluis Gausa
    • 1
  • Oscar Rodríguez-Faba
    • 1
  • Jorge Caffaratti
    • 1
  • Javier Ponce de León
    • 1
  • Lluis Guirado
    • 2
  • Carme Facundo
    • 2
  • Marco Guazzieri
    • 1
  • Andrea Guttilla
    • 1
    • 3
  • Humberto Villavicencio
    • 1
  1. 1.Department of UrologyFundació Puigvert, Autonoma University of BarcelonaBarcelonaSpain
  2. 2.Department of NephrologyFundació Puigvert, Autonoma University of BarcelonaBarcelonaSpain
  3. 3.Department of UrologyU.L.S.S. 15 “Alta Padovana”, Camposampiero HospitalPaduaItaly

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