Effect of robotic assistance on the “learning curve” for laparoscopic hand-assisted donor nephrectomy

Horgan, Santiago; Galvani, Carlos; Gorodner, M. V.; Jacobsen, Garth R.; Moser, Federico; Manzelli, Antonio; Oberholzer, José; Fisichella, P. Marco; Bogetti, Diego; Testa, Giuliano; Sankary, Howard; Benedetti, Enrico

doi:10.1007/s00464-006-9140-5

Cited by 67 publications

(70 citation statements)

References 28 publications

(34 reference statements)

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“…The authors reported that hand-assisted RALDN increased the safety of the operation by allowing rapid control of catastrophic bleeding and avoiding excessive manipulation of the kidney during extraction [9]. This report on 214 RALDN patients (2007) [10] remains the largest cohort study, and provides insight into the learning curve involved in mastering robotic-assisted transplant surgery. Notably, Horgan et al [10] [8].…”

Section: Discussionmentioning

confidence: 89%

Robotic-assisted laparoscopic donor nephrectomies: early experience and review of the literature

et al. 2011

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With over 80,000 patients in the United States awaiting kidney transplantation, renal transplant surgery continues to evolve with attractive surgical options for living donation, which include laparoscopic donor nephrectomy (LDN) and robotic-assisted laparoscopic donor nephrectomy (RALDN). LDN is currently accepted as the gold standard procedure for living donor nephrectomy; RALDN is an evolving technique and may emerge as a preferred procedure over time. We present our initial experience with RALDN from December 2007 to August 2008. Thirty-five patients who underwent RALND were retrospectively analyzed and compared with 35 age- and time (year)-matched patients who underwent LDN. The parameters analyzed were length of hospital stay (3.2 ± 0.9 days, P < 0.59), estimated blood loss (146 ± 363 ml, P < 0.36), operating time (149 ± 44 min, P < 0.23), cold ischemic time (135 ± 202 min, P < 0.19), preoperative creatinine (0.82 ± 0.26 mg/dl, P < 0.46) and postoperative creatinine (1.44 ± 1.03 mg/dl, P < 0.20). There was no statistical difference between RALDN patients with single renal artery (n = 27) and those with more than one renal artery (n = 8) kidneys. There was one serious complication requiring conversion to open laparotomy to control a bleeding renal artery stump following extraction of the kidney. One-year graft survival for the 35 recipients of RALDN was 97.1%. RALDN is feasible and compares favorably to the standard LDN procedure with good graft survival. Robotic-assisted transplant surgery is an emerging technique with potential benefits to both surgeon and patient.

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Section: Discussionmentioning

confidence: 89%

Robotic-assisted laparoscopic donor nephrectomies: early experience and review of the literature

et al. 2011

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“…The largest study published by Horgan et al [17] including 250 living kidney donors shows that the mean operative time was strongly reduced with an increasing number of RADNs performed. Janki et al [9] showed a significant improvement in total operative time after 60 RADNs performed, indicating the importance of the learning curve in RADN.…”

Section: Resultsmentioning

confidence: 99%

“…This has led to the implementation of robotic-assisted donor nephrectomy (RADN) in some centers [17]. The first series of 12 successful RADN were performed with daVSS [17].…”

Section: Live Kidney Donationmentioning

confidence: 99%

Robot-Assisted Transplant Surgery - Vision or Reality A Comprehensive Review

Stiegler¹,

Schemmer²

2018

Visc Med

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Minimally invasive surgery is standard procedure for many operations. Further refinements include the introduction of robotic surgery which is still an emerging field especially in laparoscopic surgery. Since the successful introduction of the da Vinci Robotic Surgical System, the robotic approach in organ transplantation has become of great interest in both the live donor organ retrieval and the recipient operation. Robotic surgery for kidney, liver, and pancreas transplantation is feasible. Over 700 donor nephrectomies and 100 kidney transplantations have been performed already, and robotic surgery is standard in a small number of pioneer centers; however, larger series and most importantly randomized controlled trials for the highest evidence are needed. Longer warm ischemia time and higher costs limit these procedures at the moment.

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“…Diese Operation setzt ebenfalls laparoskopisches Geschick voraus und ist mit einem signifikanten Lernkurveneffekt vergesellschaftet [17,18]. Durch Roboterunterstüt-zung berichteten Horogan et al [19] von warmen Ischämiezeiten von <2 min und einer Graft-Überlebensrate von 98%. Diese positiven Ergebnisse konnten auch bei Vorliegen von Gefäßanomalien erreicht werden.…”

Section: » Die Technischen Vorteile Vonunclassified

Nephrektomie – pro robotisch

Buse

2012

Urologe

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The last two decades have witnessed the rapid dissemination of robot-assisted laparoscopic urological surgery related to the technical advantages of this new laparoscopic tool. Master-slave systems ease intracorporeal anastomosis and the performance of technically highly demanding procedures, as reflected by a steep learning curve. Robot-assistance is particularly useful for partial nephrectomy, live-donor kidney transplantation, extended procedures, e.g. upper and lower urogenital tract resection and difficult anatomy as encountered in obese patients or patient with a history of multiple intraperitoneal procedures.

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Effect of robotic assistance on the “learning curve” for laparoscopic hand-assisted donor nephrectomy

Cited by 67 publications

References 28 publications

Robotic-assisted laparoscopic donor nephrectomies: early experience and review of the literature

Robotic-assisted laparoscopic donor nephrectomies: early experience and review of the literature

Robot-Assisted Transplant Surgery - Vision or Reality A Comprehensive Review

Nephrektomie – pro robotisch

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