Korean J Transplant.  2020 Dec;34(Supple 1):S43. 10.4285/ATW2020.OR-1175.

Robot-assisted kidney transplantation: the initial experience of single institution in Korea

• Yang SJ
• Huh KH
• Jeong WJ
• Na JC
• Han WK
• Kim EJ

• KMID: 2509176
• DOI: http://doi.org/10.4285/ATW2020.OR-1175

Abstract

Background
Minimally invasive approach using the robotic system has recently been introduced in kidney transplantation to reduce the morbidity of the open kidney transplantation and get rapid recovery after kidney transplantation. We have performed the first robotic kidney transplantation (RKT) in Korea. The aim of this study is to share initial experience and evaluate the surgical results of RKT performed in our institution.
Methods
A total of eight patients with end-stage renal disease underwent de novo living donor RKT (da Vinci surgical system) from 11th November 2019 to 25th April 2020 in Severance Hospital. RKT was done with regional hypothermia through a transperitoneal approach following a step-by-step description of the Vattikuti Urology Institute-Medanta technique. The demographics, perioperative and short-term transplant outcomes were analyzed.
Results
All eight patients successfully underwent RKT without open conversion or other surgical complications such as postoperative bleeding, leakage, and lymphocele. The incision length was about 7 cm. The mean console time was 301.2 minutes (range, 245–375 minutes) and cold ischemia time 38.7 minutes (range, 34–45 minutes), rewarming time 73.7 minutes (range, 54–88 minutes) were noted. There was no delayed graft function showing immediate graft function. However, two patients developed thrombotic microangiopathy. Except these unusual TMA cases, six patients were discharged in postoperative day 8 to 9 with mean creatinine 0.96 mg/dL (range, 0.68–1.27 mg/dL).
Conclusions
RKT with regional hypothermia may be a safe and effective minimally invasive approach in a selected group of patients showing good surgical outcomes.