Retroperitoneal robot-assisted live-donor nephrectomy: A single-center study

Abstract

Background: As the demand for kidney transplants continues to increase globally, healthcare institutions face a challenge to bridge the gap between patients waitlisted for kidney transplants and the number of donors. A major factor influencing the donor's decision is the operative risk and potential complications of the surgery. Open surgical approaches have been vastly replaced with laparoscopic donor nephrectomies as the standard of practice. However, there is a growing body of evidence pointing towards its potential superiority over laparoscopic methods. In this study, we aim to present our experience on outcomes of Robotic-Assisted Live Donor Nephrectomies (RALDN), the first series of its kind in the United Arab Emirates (UAE).

Methods: We retrospectively collected data from patients who underwent RALDN at Mediclinc City Hospital. Demographic data, laboratory investigations, and operative details were collected and analyzed.

Results: Seven patients underwent RALDN between 2021 and April 2022 at our facility. Four donors were male while three were female. Median length of hospital stay was 4 days. In our study, one of the patients suffered from a Clavien-Dindo grade IV complication which necessitated prolonged admission.

Conclusion: We conclude that RALDN is a safe method for donor kidney procurement, carrying a low risk of morbidity and mortality. This method could potentially evolve the number of kidney donors to address the issue of high kidney transplant demand.

Keywords: bowel perforation; kidney transplant; live donor nephrectomy; minimally invasive technique; robot assisted live donor nephrectomy.

Figure 1

Patient positioning.

Figure 2

Robotic port marking. Green circle: 12 mm Camera port; Blue, red and yellow circles: operating ports, including retractors; Orange arrow: Pfannenstiel incision, and Alexis Port insertion point (Perpendicular line from the umbilicus is for surgeon's guidance only).