Robotic Kidney Transplantation with Regional Hypothermia: A Step-by-step Description of the Vattikuti Urology Institute–Medanta Technique (IDEAL Phase 2a)

Menon, Mani; Sood, Akshay; Bhandari, Mahendra; Kher, Vijay; Ghosh, Prasun; Abaza, Ronney; Jeong, Wooju; Ghani, Khurshid R.; Kumar, Ramesh; Modi, Pranjal; Ahlawat, Rajesh

doi:10.1016/j.eururo.2013.12.006

Cited by 161 publications

(189 citation statements)

References 23 publications

Supporting

Mentioning

179

Contrasting

Order By: Relevance

“…This is different from what was observed by Oberholzer et al, who reported 48 and 49 min of anastomosis time in robot‐assisted and open kidney transplantation, respectively, the main difference being that no cooling technique was used/described during implantation. Another group with greater experience could reduce anastomosis time below 30 min 11. Differences such as the learning curve, hand assistance, type of da Vinci Surgical System, surgical times definition, and technique may explain these timing differences.…”

Section: Discussionmentioning

confidence: 99%

“…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. Menon et al used regional hypothermia to lower kidney graft temperature during clinical robot‐assisted transplantation 11. The allograft was cooled by repetitively delivering ice slush through a large trocar (GelPOINT) device and this technique allowed the temperature of the graft to reach 20°C before unclamping the vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Our future aim is to reproduce the clinical experience of the Chicago 10 and the Indian group 11 and implement a clinical program for robot‐assisted transplantation in obese patients who did not achieve a sufficient weight loss compatible with an open kidney transplantation 25. It is worth noting that in Europe, morbidly obese patients with end‐stage kidney disease are less frequent than in the United States; to date, our policy is to achieve weight loss by way of bariatric surgery, mainly sleeve gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Initial attempts to use robotic assistance in kidney transplantation were successful. However, the technique is currently used only in selected cases and specialized centers 9, 10, 11. Multiple groups have demonstrated the feasibility, safety, and reproducibility of robot‐assisted kidney transplantation.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Meier

Piller

Hagen

et al. 2018

American Journal of Transplantation

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Meier

Piller

Hagen

et al. 2018

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…At present, the only widely adopted minimally invasive transplant related procedure is laparoscopic donor nephrectomy. Some progressive transplant centers have performed robotic donor nephrectomies and even robotic renal transplants, but these centers are the exception and not the rule (6)(7)(8)(9). Minimally invasive surgery has been shown to reduce patient discomfort allowing for earlier mobilization, hospital discharge and return to work.…”

Section: Introductionmentioning

confidence: 99%

Robotic Trans-Abdominal Transplant Nephrectomy for a Failed Renal Allograft

Mulloy

Tan

Wolf

et al. 2014

American Journal of Transplantation

View full text Add to dashboard Cite

Minimally invasive surgery for removal of a failed renal allograft has not previously been reported. Herein, we report the first robotic trans-abdominal transplant nephrectomy (TN). A 34-year-old male with Alport's syndrome lost function of his deceased donor allograft after 12 years and presented with fever, pain over his allograft and hematuria. The operation was performed intra-abdominally using the Da Vinci Robotic Surgical System with four trocars. The total operative time was 235 min and the estimated blood loss was less than 25 cm 3 . There were no peri-operative complications observed and the patient was discharged to home less than 24 h postoperatively. The utilization of robotic technology facilitated the successful performance of a minimally invasive, trans-abdominal TN.

show abstract