V02-02 ROBOTIC ORTHOTOPIC KIDNEY TRANSPLANTATION

Abstract

You have accessJournal of UrologyMisc. Benign Disease & Transplant & Renovascular (V02)1 Sep 2021V02-02 ROBOTIC ORTHOTOPIC KIDNEY TRANSPLANTATION Francesc Vigués Julià, Begoña Etcheverry Giadrosich, Xavier Bonet Puntí, Natalia Picola Brau, Maria Fiol Riera, José Francisco Suárez Novo, and Lluis Riera Canals Francesc Vigués JuliàFrancesc Vigués Julià More articles by this author , Begoña Etcheverry GiadrosichBegoña Etcheverry Giadrosich More articles by this author , Xavier Bonet PuntíXavier Bonet Puntí More articles by this author , Natalia Picola BrauNatalia Picola Brau More articles by this author , Maria Fiol RieraMaria Fiol Riera More articles by this author , José Francisco Suárez NovoJosé Francisco Suárez Novo More articles by this author , and Lluis Riera CanalsLluis Riera Canals More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001979.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Orthotopic kidney transplant is a good alternative for patients with an end-stage renal disease non-suitable for a heterotopic kidney transplant (KT) due to severe iliac atherosclerosis or occupation of iliac fossa by previous grafts. This approach is performed through a left lumbotomy, using the splenic or renal artery, the renal vein and the native urinary tract. However, it is technically challenging and is associated with a higher rate of complications compared to conventional KT. Recently, robot-assisted kidney transplant (RAKT) has been shown to achieve excellent patient and graft outcomes, while reducing surgical morbidity. From the experience in RAKT, we have developed this technique in orthotopic transplantation. The aim of this video is to describe the technique of Orthotopic robotic assisted kidney (oRAKT). As far as we know, this is the first time described. METHODS: We present an oRAKT from a Controlled donor after cardiac death in a 65-year-old man with End-Stage Renal Disease non-suitable for a heterotopic KT due to severe iliac atherosclerosis and previously transplanted patient. RESULTS: Total surgical time was 324 min. The arterial and vein anastomoses time were 17 and 21 min respectively. A good renal reperfusion was observed after clamp removing. The estimated blood loss was 480 ml. A doppler ultrasound performed 24 hours after oRAKT showed a correct graft perfusion and the abdominal X-ray a correct catheter position. No postoperative complications were recorded. Pain was reported as minimal, no analgesic was required beyond 48h after surgery and the patient was discharged from the hospital at 9th day. The serum creatinine at the discharge day was 160 μmol/L. One year follow-up creatinine was 140 μmol/L. CONCLUSIONS: Orthotopic robotic assisted kidney transplant could provide a good minimally invasive alternative for selected patients non-suitable for a heterotopic KT and is technically feasible in centers with RAKT expertise. The potential advantages of the robotic approach are related to the reduction of lumbotomy morbidity, the better and more precise dissection of the native renal vein and splenic artery; and the more precise vascular anastomosis. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e133-e133 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesc Vigués Julià More articles by this author Begoña Etcheverry Giadrosich More articles by this author Xavier Bonet Puntí More articles by this author Natalia Picola Brau More articles by this author Maria Fiol Riera More articles by this author José Francisco Suárez Novo More articles by this author Lluis Riera Canals More articles by this author Expand All Advertisement Loading ...