Surgical outcomes of robot-assisted nephrectomy for living-donor kidney transplantation in 12 cases

Abstract

Objective To summarize the surgical experience about the robot-assisted laparoscopic nephrectomy for living-donor kidney transplantation,as well as its efficacy and safety.Methods From September 2013 to January 2014,the clinical data of 2 male and 10 female patients who were underwent robot-assisted nephrectomy for living-donor kidney transplantation in our hospital were analyzed.The mean age in those patients were 47 years old (range 38 to 60 years old).11 underwent a left nephrectomy and the 12th patient underwent a right nephrectomy.As to the receptor,all of them,including 8 male and 4 female patients,were suffered from the uremia due to the chronic glomerulonephritis.The mean age in those receptors were 26 years old (range 20 to 36 years old).The duration of hemodialysis in those patients ranged from 8 to 25 months (mean 14 months).Their transplanted kidneys were all donated from their parents.Operative time,bleeding volume,warm ischemia time,length of vein and artery preservation,surgical related complication and changing of renal function in donor were analyzed.Results All patients underwent totally robotic nephrectomy without open procedure conversion.The median console time was 140 minutes (range 110-195 min).Median intraoperative bleeding was 50 ml (range 30-120 ml).The median warm ischemia time was 170 s (range 100-280 s).The median length of vein preservation was 2.4 cm (range 1.9-3.0 cm) and 1.8 cm (range 1.4-2.3 cm) for artery.Spleen injuries occurred in two cases whcn the kidney was takcn out and splenorrhaphy was performed.The hospital stay of all donors was 5 days.None of the transplant recipients developed delayed graft functional recovery.Conclusions Robot-assisted laparoscopic nephrectomy is a safe,reliable,minimal invasive and effective procedure for living-donor kidney transplantation.More attention,however,should be paid to the spleen when the left kidney is taken out. Key words: Laparoscopic donor nephrectomy; Robotic surgery; surgical procedures; Renal transplantation