INTRODUCTION AND OBJECTIVES: As minimal invasive treatments develop, most urologists have preferred minimally invasive methods in recent years. There is a great shift through laparoscopic and robotic surgeries, as open surgery have almost faded except for some key interventions, such as kidney transplantation. In this report, we aimed to present the first 37 cases performed in first 11 months of robotic kidney transplantation, of a center with high robotic urology experience.

METHODS: Starting from January 2016, we performed 37 RKTs in Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital. Before surgery, the whole robotic procedure was thoroughly explained to the patient and informed consent was taken.

RESULTS: We performed RKT in 23 male and 14 female patients. Mean patient age was 38.1±11.5. Mean body mass index of the patients was 23.2±3.34. Mean preoperative creatinine level was 5.6±1.81 mg/dl. Mean preoperative dialysis durations ranged from 0 to 5 years. Mean operative time was 270.4±44.8 minutes. Mean warm ischemia and re-warming durations were 1.8±0.48 minutes and 56.2±17.59 minutes. We used a mean of 219.4±38.8 cc of ice slush. Mean blood loss was 173.7±42.05 cc. Mean incision length was 5.0±0.66 cm. We did not need any necessity for open conversion nor did not encounter any intraoperative complications. Two patients in our cohort suffered from ileus and had to be treated with exploratory laparotomy; which happened to be because of paralysis caused by extensive use of ice slush. Mean drain withdrawal time was 3.48±0.96 days. Patients had a hospital stay of 9.9±2.21 days. At discharge, they had a creatinine level of a mean 1.39±0.54 mg/dl and glomerular filtration rate of 60.6±23.71. Sixteen patients have a follow up of 6 months following surgery and they had a mean creatinine and glomerular filtration rate of 1.1±0.36 mg/dl and 74.2±21.2, respectively.

CONCLUSIONS: With transplantation being performed via a minimal invasive approach, more patients may be able to have kidney transplant and this important health issue may decrease significantly. We believe that the potential advantages of RAKT are related to the quality of the vascular anastomosis, the possible lower complication rate and the shorter recovery of the recipients. However, complexity of this operation should limit the surgeons. One should have great robotic experience before attempting this kind of surgery.

CITATION INFORMATION: Sahin S, Tugcu V, Yavuzsan A, Akbay F, Apaydin S. Robotic Kidney Transplantation: Bakirkoy Experience. Am J Transplant. 2017;17 (suppl 3).

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