Minimally Invasive Kidney Transplantation

Comparison of Minimal Skin Incision Technique in Living Kidney Transplantation and Conventional Kidney Transplantation

“…[ 7 ] Potential wound problems due to immunosuppressive drugs prescribed to kidney transplant recipients are particularly associated with steroid and antiproliferative agents. [ 8 ] A major point about the present minimally invasive approach is that reduction of tissue trauma seems particularly appropriate in this population, with significantly delayed wound healing and a high complication rate. [ 4 ] Due to the immunosuppressive therapy, the incidence of wound dehiscence and incisional hernia is distinctly higher in transplant recipients, in particular with the introduction of sirolimus/everolimus,[ 9 ] and it seems plausible that significant reduction of incision/tissue trauma would counteract such problems.…”

“…[ 6 8 ] The first was a careful and meticulous back-table preparation for reducing reperfusion bleeding in limited operation field: problems with even minor vessels affect the success of the procedure. [ 6 8 ] We also removed all fatty tissues outside the hilar plane during the back-table preparation and ligating even the smallest blood vessel. [ 6 ] The second was a self-retracting system to obtain an surgical field that was necessary, giving medial, vascular exposure while allowing lateral space for kidney.…”

“…[ 6 ] The second was a self-retracting system to obtain an surgical field that was necessary, giving medial, vascular exposure while allowing lateral space for kidney. [ 6 8 ] Considering the benefit of reducing trauma due to surgery and the effects of immunosuppressive drugs, one understands the importance of MIKT. [ 8 ] However, it is rather unexpected that minimally invasive KT procedures have been just limitedly reported,[ 6 8 ] and even more so when taking into consideration the wide range of sophisticated MIS procedures that have been introduced during recent years.…”

“…[ 6 8 ] Considering the benefit of reducing trauma due to surgery and the effects of immunosuppressive drugs, one understands the importance of MIKT. [ 8 ] However, it is rather unexpected that minimally invasive KT procedures have been just limitedly reported,[ 6 8 ] and even more so when taking into consideration the wide range of sophisticated MIS procedures that have been introduced during recent years. [ 1 ] The reasons may include the urge for safe handling of the kidney through sufficient access, for total control during revascularization, and the present unfeasibility of automating the vascular anastomoses.…”

“…[ 4 ] Another criticism of MIKT could be that it does not sufficiently cool the kidney before revascularization. [ 8 ] Furthermore, the technical difficulties encountered with a short renal vein is accentuated by the MIKT technique. [ 4 ] Robot-assisted KT has been introduced in limited cases, but it showed long ischemic and operation time.…”