Robot-assisted kidney transplantation (RAKT) is associated with low complication rates, rapid recovery, and excellent graft function when performed by surgeons with robotic and kidney transplantation experience, according to a European study.
In what they believe is the largest reported multicenter prospective study of RAKT, Alberto Breda, MD, of Autonoma University of Barcelona in Spain, and colleagues evaluated perioperative and early postoperative surgical outcomes among 120 patients (75 men and 45 women) from 8 European centers who underwent the procedure, of whom 118 received a kidney from a living donor. Patients had a median age at surgery of 43 years, median dialysis duration of 365 days, and a minimum follow-up period of 1 year.
Robotic surgery makes kidney donation less invasive than ever
Kidney transplantation has advanced significantly over the years, but most of the advancements – such as immunosuppressive drugs and surgery – benefit the organ recipient, not necessarily the donor. Now, thanks to robotic technology, the donation process is better than ever for the donor. “Not much has benefited the kidney donor until minimally invasive surgery and laparoscopic donor nephrectomy,” says Harrison Pollinger, D.O., a multi-organ transplant surgeon at Piedmont Transplant Institute.
Previously, a kidney was removed from a live donor through open nephrectomy, which required a large incision and at least a week or more in the hospital for recovery. Laparoscopic donor nephrectomy was designed to be much less invasive. It has increased awareness of kidney donation, says Dr. Pollinger, because it is a minimally invasive procedure.
This method allows the donor to recover faster and require less pain medication post-operatively. Robotic technology further improves the procedure. “Our donors are going home within 24 hours and the incisions are very small,” Dr. Pollinger says. “The robot allows us to place the extraction site (where the kidney comes out of the body) in a different location than traditional laparoscopy, in a less painful, lower abdominal incision.”
Robotics improves kidney donation process
“With the higher definition visualization, the finer movements of the robotic instruments, the increased precision – all of that translates into less traumatic surgery for the donor,” he says. “When you’re removing something that doesn’t need to be transplanted, you can make your incisions even smaller because you can place the target organ in a bag and pull it out through a very small incision.”
The average kidney is approximately the size of a fist. During a nephrectomy, the surgical team will place a small bag inside the donor. The kidney can then be removed in the bag through a small incision. “Robotics in the field of transplantation is sort of in its infancy,” says Dr. Pollinger. “There are very few and select programs nationally that have incorporated robotics into their live donor nephrectomy program.”
Piedmont is the first program in Georgia to perform robotic donor nephrectomy and is currently the only transplant program in the state that offers this procedure. “Others will follow the path that we’ve forged because robotics is melding into the field of surgery – any surgery,” says Dr. Pollinger. “I think robotics is here to stay and is only going to get better.” Robotic surgery gives kidney donors the opportunity to save a life, with less invasive surgery and a faster recovery. For more information on robotic donor nephrectomy.