Robotic-assisted laparoscopic donornephrectomy: initial results and comparison with the hand-assisted laparoscopic technique

M.M. Idu, M. Willems, K. van de Pant, F.J. Bemelman

Wednesday 4 march 2020

17:10 - 17:20h at Theaterzaal

Parallel session: Parallel sessie VI – Klinische abstracts

Background: To evaluate morbidity and renal function of the donor and recipient during robotic-assisted laparoscopic donornephrectomy and comparison with the hand-assisted laparoscopic technique.

Methods: Retrospective study of our first 27 consecutive robotic-assited laparoscopic donornephrectomy procedures (RA). This was compared with an matched group of 27 hand-assisted laparoscopic procedures (HA). Matching was done according to donor aspects (age, gender, side and operating surgeon). The Da Vinci Xi robot was used and they were totally robotic procedures. 23 left-sided and 4 right sided robotic procedures. 10 of 27 robotic procedures had a complex vascular anatomy. The BMI range of the RA group was 19-32. Donor and recipient variables were analyzed.

Results: The mean operating time was 206 min for the RA group and 141 min for the HA group. The median warm ischemia time was 3 min for the RA group and 2 min for the HA group. The median bloodloss was 20 ml for the RA group and 50 ml for the HA group. These were statistically significant differences. The post-operative pain-score, post-opertaive hospital stay and complications for the donors were identical in both groups. There was no significant differences in renal function at 1 week (serum creatinine/eGFR in the RA group 181/42 vs HA group 180/39) and 1 month (serum creatinine/eGFR in the RA group 162/48 vs HA group 146/47) after transplantation.

Conclusions: Robotic-assisted laparoscopic donornephrectomy is an evolving technique which provide a highly detailed three-dimensional visualization of the operative field, 360 degree rotating (Endowrist) instruments and better ergonomics for the operating surgeon. Robotic-assisted laparoscopic donornephrectomy is safe for the donor and for the graft.