Authors: S Horgan C Galvani M V Gorodner G R Jacobsen F Moser A Manzelli J Oberholzer M P Fisichella D Bogetti G Testa H N Sankary E Benedetti
Publish Date: 2007/02/08
Volume: 21, Issue: 9, Pages: 1512-1517
Abstract
The number of livingrelated donor kidney transplantations have increased since the advent of minimally invasive surgery Robotic technology has emerged as a promising alternative to laparoscopic techniques The authors reviewed their institution experience with robotic handassisted donor nephrectomies RHADNsBetween August 2000 and April 2006 273 robotically assisted left donor nephrectomies were performed using a handassisted technique Prospectively collected information for 214 patients regarding complications hospital stay blood loss warm ischemia time operative time and outcomes is presentedThe cohort of donors included 110 men and 104 women with a mean age of 36 years range 18–61 years These donors included 86 African Americans 46 Caucasians 74 Hispanics and 8 of other races Left renal artery anomalies were found in 61 patients 29 Four patients underwent conversion to open surgery The hospital stay was 23 days range 1–8 days the blood loss 82 ml range 10–1500 ml and the mean warm ischemia time 98 s range 50–200 s The operative time was 201 min range 100–320 min for the first 74 cases 129 min range 65–240 min for the second 70 cases and 103 min for the last 70 cases p 0001 for an overall average of 150 min Complications decreased significantly after the first 74 cases The 1year patient survival rate was 100 and the 1year graft survival rate was 98 The average recipient creatinine at 6 months was 14 mg/dlSpecific changes in operative technique over time have improved patient safety and diminished complications with RHADN Currently RHADN can be performed expeditiously with a minimal rate of complications and conversion to open procedure by a surgical team with appropriate training and experience
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