*Purpose: Robotic donor nephrectomy is increasingly popular, however, studies have not yet shown a clear benefit. The main aim of this study is to evaluate whether robotic donor nephrectomy has any impact on postoperative pain control, patient-controlled analgesia (PCA), epidural or peripheral block use. Additionally, the rate of donor chyle leak and recipient slow graft function (24hr creatinine reduction ratio <40%) were compared.

*Methods: Patients who have undergone a donor nephrectomy between June 2017 and March 2020 were studied and split in two groups: robotic donor nephrectomy (n=34) and laparoscopic donor nephrectomy (n=50). Patients were asked to rate their pain intensity in a scale of 1-10, and the maximum pain score obtained in the first 24 hours was compared using a Mann Whitney test. The number of patients who required a PCA, epidural or peripheral block in the first 24 hours was compared using Fisher’s exact test. The rate of chyle leak and slow graft function (SGF) was analyzed using Fisher’s exact test. Slow graft function was defined as less than 40% creatinine reduction ratio within 24 hours.

*Results: No statistically significant difference was obtained with regards to postoperative pain control. Fewer patients in the robotic nephrectomy group required a PCA, epidural or peripheral block (Table 1). None of the robotic donors developed a chyle leak, as opposed to two laparoscopic donors. Slow graft function was only encountered in the laparoscopic donor group. None of these findings were significant (Table 2).

*Conclusions: This single-center retrospective study shows that robotic donor nephrectomy results in a decreased use of PCA and regional anesthesia blocks, which will help expedite donation as operative times continue to improve. Furthermore, the absence of chyle leaks and SGF in the robotic donor group is a strong incentive to continue implementing this new technology.

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