Robotic bilateral nephrectomy for large polycystic kidney disease.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrology

Background:

• Autosomal Dominant Polycystic Kidney Disease (ADPKD) often leads to enlarged kidneys requiring nephrectomy.
• Traditional nephrectomy can be challenging for significantly enlarged kidneys.

Purpose of the Study:

• To describe the technique and review outcomes of synchronous robotic bilateral nephrectomy for large kidneys in ADPKD patients.
• To evaluate the feasibility and safety of using da Vinci XI and da Vinci Single Port platforms for this procedure.

Main Methods:

• Retrospective review of robotic bilateral nephrectomy cases from January 2020 to present.
• Data collected included patient demographics, preoperative imaging, indications for surgery, renal function, and perioperative/postoperative outcomes.

Main Results:

• Fourteen cases were included, with the largest kidney measuring 32 cm.
• Median operative time was 299 minutes, with a median estimated blood loss of 75 cc.
• Low complication rates were observed, including no intraoperative complications or open conversions; two patients were readmitted within 30 days.

Conclusions:

• Robotic bilateral nephrectomy is a viable and effective option for ADPKD patients indicated for native nephrectomy.
• The technique demonstrates favorable operative times and outcomes, even for very large kidneys.