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Copyright (c) 2020 Proceedings on Minimally Invasive Surgery
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Background: Robotic assisted kidney donor surgery represents one of the most advanced surgical techniques for living kidney donation.
Material and Methods: We present our initial experience with 37 consecutive patients who underwent robotic assisted living kidney donation from September 2013 to May 2018.
Results: Within the last 5 years the amount of robotic assisted living kidney donation almost quintupled. A total of 19 left (51%) and 18 (49%) right kidneys were used for transplantation. Mean donor age was 53 (range: 35-70). The average total operative time was 151+-27 minutes with no difference between patients with single 153+-27 or multiple (n=8; 22%) 144+-29 renal arteries or veins. Interestingly, right donor nephrectomy (139+-22) was significantly faster than left (163+-27) nephrectomy. Postoperative blood transfusions were necessary in n=1 (2,7%) patient. No conversion to open surgery was performed. Clavien Dindo Grade <IIIb complication occurred in (n=4) 10,8%. Grade IV and V complications did not occur. Mortality was 0%.
10 kidneys (27%) were transplanted across the AB0 barrier, requiring therapeutic apheresis as well as T and B cell directed immunosuppressive therapy. One year graft survival was 97%.
Discussion and Conclusion: Robotic assisted living kidney donation is an emerging minimally invasive surgical technique which facilitates excellent perioperative and short-term outcomes.