Robot-assisted laparoscopic retroperitoneal donor nephrectomy: a safe and efficient improvement.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Transplantation Surgery

Background:

• Living donor nephrectomy is crucial for kidney transplantation.
• Traditional laparoscopic techniques have limitations, including longer operative times and risks of abdominal complications.
• Robot-assisted surgery offers potential advantages for donor nephrectomy.

Purpose of the Study:

• To present the robot-assisted laparoscopic retroperitoneal donor nephrectomy technique.
• To evaluate the safety and feasibility of this minimally invasive approach for living kidney donors.

Main Methods:

• A retrospective study of 218 living donors undergoing robot-assisted laparoscopic retroperitoneal donor nephrectomy from June 2016 to December 2020.
• Perioperative data including operative time, warm ischemia time, length of stay, and complications were collected and analyzed.
• A cumulative summation (CUSUM) learning curve was used to assess surgical proficiency.

Main Results:

• The mean operative time was 115.4 minutes, with a warm ischemia time of 206.6 seconds.
• Complication rates were low (10.1%), with only 1.4% experiencing Clavien–Dindo IIIa complications.
• Surgical proficiency was reached after 33 cases, with subsequent mean operative time of 100.4 minutes and warm ischemia time of 142.5 seconds.

Conclusions:

• Robot-assisted laparoscopic retroperitoneal donor nephrectomy is a safe and efficient procedure.
• This technique demonstrates advantages such as shorter operation times and avoidance of abdominal organ interference.
• It represents an effective option for living donor nephrectomy, enhancing donor outcomes.