Robotic-assisted laparoscopic donor nephrectomy for kidney transplantation

Horgan, Santiago; Vanuno, Daniel; Sileri, Pierpaolo; Cicalese, Luca; Benedetti, Enrico

doi:10.1097/00007890-200205150-00018

Cited by 178 publications

(111 citation statements)

References 8 publications

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“…The strengths of our study include the following: 1 the analysis of key factors of robot‐assisted kidney transplantation in a preclinical setting; 2 the implementation of a novel intra‐abdominal cooling system designed to intra‐operatively cool the donor kidney; and 3 a detailed and real‐time analysis of kidney temperature starting before kidney retrieval and pursued up to complete reperfusion. Several factors indicate that temperature control is of crucial importance in robot‐assisted kidney transplantation: in the study by Oberholtzer et al, the robotic group had 1.4‐times higher creatinine levels at discharge (p < 0.05), more delayed graft function (DGF) (p > 0.05, not statistically significant), and more rejection episodes (p > 0.05, not statistically significant) 10.…”

Section: Discussionmentioning

confidence: 99%

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Meier

Piller

Hagen

et al. 2018

American Journal of Transplantation

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Robot‐assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra‐abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra‐abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p‐values < 0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p < 0.001). Magnetic resonance imaging parenchymal heterogeneities and histologic ischemia–reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot‐assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra‐abdominal cooling system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia–reperfusion injuries.

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Section: Discussionmentioning

confidence: 99%

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Meier

Piller

Hagen

et al. 2018

American Journal of Transplantation

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“…La introducción de la cirugía robótica pudiera mejorar los resultados quirúrgicos en la nefrectomía del donante vivo 10 . Horgan y colaboradores describieron los primeros 12 casos de nefrectomías del donante laparoscópica asistida por robot utilizando la técnica mano asistida 11 . El sistema robótico mejora la destreza y visión del cirujano permitiendo una visión de microcirugía en un ambiente laparoscópico 12 .…”

Section: Discussionunclassified

Nefrectomía Robótica Del Donante Vivo Para Trasplante: Primer Caso en Latinoamérica

Ruiz

F²,

et al. 2014

Rev Chil Cir

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Living robotic donor nephrectomy. The first case in Latin AmericaIntroduction: Living donor nephrectomy is the best alternative of treatment for patients with chronic renal disease. Even though open surgery remains the gold standard for donor nephrectomy, laparoscopic surgery has become a feasible alternative in referral centers. To minimize the long learning curve associated with this procedure, some centers have introduced robotic donor nephrectomy as a surgical option. Aim: To present the first robotic-assisted laparoscopic donor nephrectomy in Latin America. Clinical case: The donor is a 50 years old male, living-related to the recipient by affinity (husband/wife). The recipient is a 54 years old female with history of end-stage renal disease waiting to initiate dialysis program. A left transperitoneal robotic-assisted laparoscopic nephrectomy employing the da Vinci Si ® (Intuitive Surgical, Sunnyvale CA.) is performed. Mean operative time was 188 minutes with an estimated blood loss of 300 ml. Mean ischemia time was 6 minutes. The graft presented immediate function. Both patients were discharged at 72 h. Conclusion: Living donor robotic-assisted laparoscopic nephrectomy is a safe and viable procedure. Larger series are needed to establish its role.

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“…Some authors agree that its simple presence is an indication for repair, especially in pregnant patients or in any woman who desires children. 2,10 Aneurysm size is another parameter. Some authors will recommend observation for aneurysms less than 1 cm in asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic robotic nephrectomy was performed using a previously described technique. 10 The kidney including the artery, vein, ureter, and defatting, was dissected at the back bench. After the structures were skeletonized, we addressed the aneurysm.…”

Section: Case Reportmentioning

confidence: 99%

Renal Artery Aneurysm in Robotic Donor Nephrectomy: A Case Report

Tzvetanov¹,

Spaggiari²,

Jeon³

et al. 2012

Exp Clin Transplant

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Objectives: With the current disparity between donor organ availability and recipient need, creative techniques help optimize the use of available organs. We present a case of a woman, who was worked-up as a kidney donor, who was incidentally found to have a saccular aneurysm on her renal artery. The patient was asymptomatic, normotensive, and had normal renal function. Materials and Methods: We performed a laparoscopic robotic donor nephrectomy, repaired the aneurysm on the back table, and transplanted the organ into the recipient. Results: The donor underwent a successful robotic nephrectomy, successfully eradicating any risk of aneurysmal complications; the recipient received an anatomically normal organ with excellent function. Conclusions: An altruistic act by the donor identified a potentially fatal lesion, which was not only remedied, but the intended donation proceeded when a creative approach was used.

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Robotic-assisted laparoscopic donor nephrectomy for kidney transplantation

Abstract: As technology continues to evolve, robotic-assisted surgery has the potential to become a widely used attractive alternative to standard laparoscopic donor nephrectomy.

Cited by 178 publications

References 8 publications

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Nefrectomía Robótica Del Donante Vivo Para Trasplante: Primer Caso en Latinoamérica

Renal Artery Aneurysm in Robotic Donor Nephrectomy: A Case Report

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