Robot-Assisted Harvesting of Kidneys for Transplantation and Global Complications for the Donor

Donor and Recipient Outcomes following Robotic-Assisted Laparoscopic Living Donor Nephrectomy: A Systematic Review

“…These data are coherent with the evidence that WIT up to 720 seconds do not correlate with graft function [16, 27]. Major limitations of current robotic systems are high costs and lack of haptic feedback [15, 28, 29]. However, daily use of the robot may reduce robotic costs mainly in a high-volume institute if the system is made available to multidisciplinary surgical teams [15].…”

“…In their study, Horgan et al found that the postoperative complication rate dropped from 24% in the first 74 cases to a steady rate of 7% in the last part of their cohort [3]. Only 4 studies graded complications according to the Clavien Classification system by showing a high prevalence of Grades I and II complications [12, 13, 15, 16]. Comparative studies failed to find statistically significant differences between RALDN, ODN, LDN, and HARP in terms of postoperative complications [12, 13, 16].…”

“…The introduction of precise surgical robotic systems, like the da Vinci system, has expanded surgeons' ability to complete complex surgical tasks in a minimally invasive fashion. Some authors hypothesized that robotic assistance could result in a shorter and simpler learning curve for the procurement of kidneys from living donors and that it could enable an easier and more efficient management of complications [15]. By decreasing the learning curve for difficult surgical tasks, surgical robots may also expand the number of available surgeons for complex interventions as well as allow newer surgeons to quickly master these procedures [16].…”

“…Interestingly, most conversions occurred during the early phase of the learning curve. Giacomoni et al hypothesized that the use of the robotic assistance can help to avoid the open conversion in cases of acute bleeding as it may facilitate the repair of vascular lesions [15]. WIT has traditionally represented a major concern during donor nephrectomy as it has been thought that any increase in this parameter would have translated into a poor graft function [23].…”

“…Shorter LOS makes the RALDN procedure more convenient for the donor by allowing him to return as soon as possible to routine activities [5]. In a systematic review and meta-analysis of published work relative to 32,038 nephrectomies following different surgical techniques, Kortram et al reported a global complication rate of 9.3% with complication rate after LDN being 23% [15, 26]. The present review demonstrates that the incidence of early postoperative complications is similar between RALDN and LDN.…”