Initial Experience with Robot-Assisted Nephrectomy for Living-Donor Kidney Transplantation: Feasibility and Technical Notes

BackgroundRobot-assisted surgery provide endowrist instruments and 3-dimensional visualization of the operative field that are improvements over traditional laparoscopy. The few research studies published so far have demonstrated that living-donor nephrectomy using the robot-assisted technique is safe and feasible, providing advantages for patients.MethodsSince November 2009, we performed 20 robot-assisted living-donor nephrectomies. Eight patients underwent hand-assisted robotic nephrectomy, whereas 20, totally robotic nephrectomy.ResultsMedian intraoperative bleeding was 174 mL (range, 10–750) but no patient needed intraoperative transfusion with blood cells. The median warm ischemia time was 3.16 minutes (range, 0.30–6.5). there was no case of conversion to an open procedure. The median operative time was 311 minutes (range, 85–530); the median console time was 160 minutes (range, 135–220).ConclusionRobot-assisted living-donor kidney recovery was a safe and effective procedure. The totally robotic recovery is an evolving technique. The prospect of robotic staplers, endowrist ligature, and robotic single port may further increase these advantages.