Robotic kidney transplantation.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Transplantation Surgery

Background:

• Kidney transplantation is the optimal treatment for end-stage renal disease, surpassing dialysis in survival and quality of life.
• The surgical approach for kidney transplantation has remained largely unchanged, relying on open surgery for decades.
• Robotic surgery has demonstrated reduced morbidity in various fields, prompting consideration for robot-assisted kidney transplantation (RAKT).

Purpose of the Study:

• To evaluate the safety and feasibility of robot-assisted kidney transplantation (RAKT) as an alternative surgical approach.
• To discuss the current limitations and future potential of RAKT in diverse patient populations and settings.

Main Methods:

• Standardization of the RAKT technique since 2014 through international collaboration.
• Implementation of RAKT programs in multiple centers worldwide.
• Ongoing refinement of robotic platforms and multicenter collaborations.

Main Results:

• RAKT has shown promising results regarding safety and feasibility in various centers.
• Current RAKT application is primarily in living donor settings due to specific challenges.
• Challenges include prolonged rewarming, a steep learning curve, and difficulties in complex cases (obesity, atherosclerosis, deceased donors, pediatric recipients).

Conclusions:

• RAKT is emerging as a viable alternative to traditional open kidney transplantation.
• Technological advancements and collaborative efforts are overcoming existing limitations.
• RAKT is expanding its applicability, offering a less invasive option for more patients.