Initial experience with robotic-assisted kidney transplantation: A single-centre descriptive, retrospective study...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Transplantation Surgery

Background:

• Robot-assisted kidney transplantation (RAKT) is non-inferior to open kidney transplantation (OKT), especially for obese patients.
• This study reports initial single-center experience with RAKT incorporating technical modifications.

Purpose of the Study:

• To evaluate the feasibility and safety of RAKT with specific technical modifications.
• To compare outcomes of RAKT versus OKT in a matched cohort.

Main Methods:

• Retrospective analysis of 10 RAKT cases and 30 propensity score-matched OKT controls (Sept 2020-Mar 2021).
• Technical modifications included polyglactin mesh wrapping, continuous cooling, and a custom robotic arterial punch.
• Exclusion criteria for RAKT included BMI >35 kg/m², severe atherosclerosis, and prior complex abdominal surgery.

Main Results:

• RAKT operative time was longer (263 min vs. 185 min), but warm ischemia time was similar (52.2 min vs. 3.2 min).
• Graft survival was 100% at 60 months in both RAKT and OKT groups.
• No incisional hernias occurred in RAKT patients, compared to 6.7% in OKT controls; 30-day complication rates were similar (10% vs. 20%).

Conclusions:

• RAKT with technical modifications is feasible in experienced centers.
• The use of polyglactin mesh for graft stabilization and cooling warrants further investigation.
• While preliminary, results support RAKT safety and potential advantages, aligning with larger studies.