Introducing Robot-Assisted Laparoscopic Donor Nephrectomy after Experience in Hand-Assisted Retroperitoneoscopic...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Transplant Surgery

Background:

• Robot-assisted laparoscopic donor nephrectomy (RALDN) enhances surgical precision, flexibility, control, and vision, potentially improving donor safety.
• This study introduces the initial series of RALDN, comparing it with the established hand-assisted retroperitoneoscopic donor nephrectomy (HARPDN) technique.

Purpose of the Study:

• To compare the initial outcomes of robot-assisted laparoscopic donor nephrectomy (RALDN) with hand-assisted retroperitoneoscopic donor nephrectomy (HARPDN).
• To evaluate donor safety and graft function following both surgical approaches.

Main Methods:

• A retrospective analysis of 12 RALDN and 27 HARPDN procedures performed between March 2018 and July 2018.
• Data collected included demographics, operative duration, ischemia times, blood loss, hospital stay, complications, and serum creatinine levels.

Main Results:

• Demographics were similar between the RALDN and HARPDN groups.
• RALDN demonstrated significantly longer operation times and warm ischemia times (P < .001).
• No major postoperative complications were observed in either group, with good kidney function evident at 5 days and 1 month post-transplant.

Conclusions:

• RALDN is a safe alternative for donor nephrectomy, particularly for candidates unsuitable for HARPDN.
• Despite longer operative times, RALDN does not negatively impact donor or recipient outcomes.
• Centers experienced in hand-assisted techniques can safely introduce robot-assisted donor nephrectomy.