This early experience suggests that robotic surgery is a safe and effective alternative to conventional laparoscopic surgery. We believe that robotic surgery, with its ability to restore the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, will allow us to perform complex procedures with greater precision and confidence and better results.

As technology continues to evolve, robotic-assisted surgery has the potential to become a widely used attractive alternative to standard laparoscopic donor nephrectomy.

Laparoscopic repair of incisional and larger hernias is a technically demanding procedure that requires a longer operative time. In contrast to PVH repair, laparoscopic IVH repair usually cannot be performed on an outpatient basis. Surgeons need not be discouraged from recommending the laparoscopic approach for patients with large IVHs or with severe obesity because the morbidity remains low.

The da Vinci robotic system became available at our institution in late August 2000. We decided to use this system to perform robotically assisted laparoscopic donor nephrectomies. A prospective study was conducted of 10 consecutive patients who underwent robotically assisted laparoscopic donor nephrectomy between January and May 2001. The mean operative time was 166 minutes. The mean hospital stay was 1.8 days. The need for parenteral pain medication was limited to the first postoperative day. All kidneys were transplanted successfully; no rejections occurred. This early experience suggests that the results of robotically assisted laparoscopic donor nephrectomy are similar to those of laparoscopic donor nephrectomy. We believe that robotic surgery, which enables regaining of the hand-eye coordination and three-dimensional view lost in laparoscopic surgery, allows us to perform the donor nephrectomy with greater precision, confidence, and comfort.