V6-10: Robotic kidney transplant – our initial experience and technique.

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INTRODUCTION

Kidney transplant is the treatment of choice for CKD stage 5. Though open surgery is the gold standard, it has disadvantages like pain, wound related morbidity and inferior cosmesis. Therefore, minimally invasive surgical techniques are being established. Our objective is to present our initial experience and technique of robotic kidney transplant.

METHODS

We retrospectively studied twelve procedures conducted from April 2016 to October 2016. The demographic, operative, complication, and outcome data were analysed. Kidney was wrapped in an ice slush jacket and then inserted into the abdomen of the recipient through a midline umbilical (9 patients) or Pfannenstiel incision (three patients). A Gel-point port was used to seal the mid-line incision. The gel point was used to introduce kidney, ice-slush and a vascular punch for arteriotomy. Renal arterial anastomosis was done end to side to external iliac artery and renal venous anastomosis end to side to external iliac vein.

RESULTS

Age of patients ranged from 9 to 50 years. The combined arterial and venous anastomosis time ranged from 35 to 50 minutes. Mean operative blood loss 120± 20 ml. Mean hospital stay of 8 days. There were no surgical complications and no conversions to open. Mean serum creatinine at discharge, at one & 3 month were 2.6 mg/dl; 1.2 mg/dl & 1.3 mg/dl respectively.

CONCLUSION

Robotic approach confers advantages of decreased wound morbidity, better cosmesis and no lymphocele. However, long term follow up of large number of patients is needed to establish its place. It is more expensive than open procedures.

Funding: None