*Purpose: To provide, in a video format, tips and tricks for surgical steps of the single-port robotic extraperitoneal kidney transplantation.

*Methods: Thirteen patients underwent single-port robotic kidney transplantation with kidneys placed in the right iliac fossa. Patients are placed in the supine position with the bed slightly flexed, tilted toward the left side, and put in a 15° Trendelenburg position. A 5-cm infraumbilical incision is made and the extraperitoneal space is developed. The da Vinci SP robot (Intuitive Surgical, Sunnyvale, CA, USA) is docked per the floating docking technique using a GelPOINT access platform (Applied Medical Resources Corp, Rancho Santa Margarita, CA, USA). The external iliac artery and vein are dissected using monopolar scissors. Benching of the kidney is performed using LigaSure device (Medtronic, Dublin, Ireland). The posterior surface of the artery and the vein are marked. A 14 cm ureteral stent is placed. A 3-0 chromic suture is placed in the lower pole for nephropexy. The kidney is wrapped with a blue glove with cut-off fingers covering the lower pole. A 12 mm port is placed through GelSeal® cap and 400 mL of ice is introduced. The kidney is introduced through the same incision. The venous and arterial anastomoses are performed using one 6-0 GORE-TEX^® suture (Gore Medical, Flagstaff, AZ, USA) for each of them and in a running fashion. Each suture is tied on itself at the distal and proximal corners. Bulldog clamps (Scanlan, Saint Paul, MN, USA) are used for vascular control. Arteriotomy is made using a sleeve-protected scalpel. Aortic punch is introduced directly through the abdominal wall. After completion of the anastomosis, the kidney is repositioned to the space above the psoas muscle. Ureteroneocystostomy is performed using 4-0 Vicryl sutures. The kidney is fixed to the lateral abdominal wall. The robot is undocked and the wound is closed.

*Results: Surgery was successfully completed in all patients without conversion to open surgery. There were no intra or postoperative complications ≥ Clavien grade 2. Median (IQR) vein and artery anastomosis times were 26 (24-28) and 37 (33-40) minutes. Patients were discharged home in 2-3 days. Mean (SD) creatinine at 6 and 12 months were 1.31 (0.24) and 1.30 (0.16) mg/dL.

*Conclusions: We described tips and tricks for technical aspects of the single-port robotic extraperitoneal kidney transplantation.

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