*Purpose: Robotic assisted live donor nephrectomies (RDN) have continued to gain popularity in recent years. Our purpose was to investigate the difference in outcomes between these techniques of living donor kidney transplantation

*Methods: This is a retrospective study comparing surgical techniques for live donor nephrectomies. The results of 58 consecutive live donor nephrectomies performed from May 2016- October 2019, 36 laparoscopic followed by 22 robotic, were reviewed. The two surgical approaches were compared by collecting information on operative length, intraoperative blood loss, intraoperative fluid administered, PRN opioids administered in hospital, length of stay, and creatinine at discharge

*Results: Overall, donor demographics and clinical characteristics were similar between groups. In the RDN and LDN samples, operations were performed on patients with similar gender distribution (71% vs. 67% female p=0.63), BMI (26.1 vs. 27.3 p= 0.23), and age (42.6 vs 47.3 p=0.16). Left nephrectomies were dominant in both groups (55% vs. 53% p=0.73). There was no statistical difference in creatinine at discharge (1.08 vs 1.38 p=0.36), however there was a statistical different in GFR at discharge (69 vs 60.2, p = 0.22). There was no statistical difference in GFR at any regular follow-up periods. RDN patients experienced an insignificant decrease in average length of stay (3.04 vs. 3.42 days p=0.47) and in Morphine milligram equivalents administered during their stay (238 vs. 327 p=0.44).

*Conclusions: This study has shown that RDN is a safe and effective alternative surgical approach when compared to LDN. The decrease fluid administration may reflect the decreased tissue manipulation allowed for by robotic assistance, or a shift in fluid management during robotic procedures. The robotic approach trended toward significant decreases in length of stay, and narcotics administered so studies with larger samples are needed to better distinguish these surgical approaches

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