Robotic Assisted Transplant Nephrectomy: Case Series and Training Model for Improving Adoption

Area of Science:

• Nephrology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Open transplant nephrectomy for failed renal allografts is invasive, carrying significant risks.
• Minimally invasive surgery improves outcomes in many procedures.
• Robotic assisted transplant nephrectomy (RATN) may offer substantial patient benefits.

Observation:

• The study utilized high-fidelity hydrogel models for simulated RATN and retrospectively analyzed five institutional cases.
• Data collected included intraoperative and postoperative variables, patient demographics, and outcomes.
• Common indications for RATN included abdominal pain due to rejection.

Findings:

• Simulated RATN took an average of 67.33 minutes.
• Five patients underwent RATN, with a mean age of 47 years.
• Mean blood loss was 188 mL, operative time was 243 minutes, and length of stay was 4.5 days.
• Minor intraoperative cystotomies occurred in two cases, and one patient was readmitted for an intra-abdominal abscess.

Implications:

• This study supports the feasibility of RATN.
• The findings suggest good outcomes for RATN in this patient cohort.
• RATN represents a promising alternative to open transplant nephrectomy.