V03-02 ORTHOTOPIC ROBOT-ASSISTED KIDNEY TRANSPLANTATION: STEP-BY-STEP

Abstract

You have accessJournal of UrologyCME1 Apr 2023V03-02 ORTHOTOPIC ROBOT-ASSISTED KIDNEY TRANSPLANTATION: STEP-BY-STEP Francesc Vigués Julià, Begoña Etcheverry Giadrosich, Arnau Abella Serra, José Ignacio Pérez Reggeti, Maria Fiol Riera, Pol Sanz Serra, José Francisco Suárez Novo, Manel Castells Esteve, and Lluis Riera Canals Francesc Vigués JuliàFrancesc Vigués Julià More articles by this author , Begoña Etcheverry GiadrosichBegoña Etcheverry Giadrosich More articles by this author , Arnau Abella SerraArnau Abella Serra More articles by this author , José Ignacio Pérez ReggetiJosé Ignacio Pérez Reggeti More articles by this author , Maria Fiol RieraMaria Fiol Riera More articles by this author , Pol Sanz SerraPol Sanz Serra More articles by this author , José Francisco Suárez NovoJosé Francisco Suárez Novo More articles by this author , Manel Castells EsteveManel Castells Esteve 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.0000000000003241.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Orthotopic kidney transplant is an 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) step by step, and our series of cases. METHODS: We present the ORAKT technique from different cases using splenic or renal artery. Some strategies to vessel dissection and preparation are also described. RESULTS: 5 ORAKT were done: 4 cases from cadaveric donor and 1 case from living donor. 1 arterial anastomosis was performed to the renal artery, 4 to the splenic artery. Surgical and functional data are shown in Table 1. 24 hour ultrasound is done in all cases, and the ureteral stent is removed at 4 week. CONCLUSIONS: ORAKT provides a minimally invasive alternative for some selected patients non-suitable for a heterotopic KT and is technically feasible in centers with robotics kidney transplant expertise. The potential advantages of the robotic approach are related to the reduction of lumbotomy morbidity, the better and precise dissection of the native renal vessels and splenic artery and the more precise vascular anastomosis. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e246 Advertisement Copyright & Permissions© 2023 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 Arnau Abella Serra More articles by this author José Ignacio Pérez Reggeti More articles by this author Maria Fiol Riera More articles by this author Pol Sanz Serra More articles by this author José Francisco Suárez Novo More articles by this author Manel Castells Esteve More articles by this author Lluis Riera Canals More articles by this author Expand All Advertisement PDF downloadLoading ...