Robot-assisted laparoscopic donor nephrectomy: surgical feasibility and technique

BACKGROUND: Laparoscopic donor nephrectomy (LDN) is currently accepted as the gold standard procedure for living donor nephrectomy. Robot-assisted LDN (RALDN), an evolving procedure, has recently shown potential to ultimately emerge as the preferred procedure. Here, we report our experience and the surgical technique followed for employing RALDN for living donation. METHODS: This retrospective study involved 56 consecutive patients who underwent RALDN between January 2015 and August 2018. Intraoperative and postoperative functional outcomes were analyzed and compared with the 45 patients who underwent hand-assisted LDN (HALDN) between May 2011 and December 2014. RESULTS: Mean procedure time for RALDN was 150 (range 90–210) min, and mean overall intraoperative blood loss was <100 (range 50–200) mL. Mean warm ischemic time recorded was 2 (range 1–5) min. Intraoperative complications, including blood transfusion or open conversion, did not occur in any patient. CONCLUSIONS: The procedural results of RALDN were comparable or superior to HALDN. Our RALDN approach is safe and feasible, and the procedure appears to be significantly easier for the surgeon. We suggest that our findings be externally validated to reassure reproducibility of the measurement in a prospective evaluation.