Initial Experience With Single-Port Robotic Donor Nephrectomy Using the da Vinci SP System: A Case Series Evaluating...

Minimally invasive techniques for living donor nephrectomy have advanced considerably, with robotic-assisted approaches offering improved visualization, reduced morbidity, and enhanced cosmesis. Single-port robotic donor nephrectomy (SP-RDN), utilizing the da Vinci SP platform, further minimizes the surgical footprint while aiming to maintain safety and efficacy. This case series presents our initial experience with SP-RDN, focusing on perioperative outcomes and early postoperative renal function.

We retrospectively reviewed six consecutive SP-RDNs performed between December 2023 and April 2025. Demographic data, operative parameters, and renal function markers were analyzed. All procedures were performed via a periumbilical incision using the da Vinci SP system by two surgeons at our institution. Perioperative outcomes, including operative time, estimated blood loss (EBL), warm ischemia time (WIT), and hospital stay, were assessed. Renal function was monitored using serum creatinine and estimated glomerular filtration rate (eGFR) preoperatively, on postoperative day (POD) 0 and POD1, and at first follow-up.

Mean donor age was 42 years (range 24-69), with an average BMI of 22.8 kg/m². Three nephrectomies each were performed on the right and left sides; three patients had multiple renal arteries. Mean operative time was 211 min, EBL was 65 mL, and mean WIT was 7.6 min. No intraoperative or major postoperative complications occurred. eGFR declined from a preoperative mean of 108.6 to 70.8 mL/min/1.73m² on POD1, partially recovering by the first postoperative visit.

SP-RDN is a feasible and safe approach for living donor nephrectomy, with favorable early outcomes. Larger studies are needed to confirm its advantages over traditional techniques.