Orthotopic robot-assisted kidney transplantation: first case report

Vigués, F.; Bonet, Xavier; Etcheverry, Begoña; Fiol, Maria Isabel Pomar; Suárez-Novo, José Francisco; Breda, Alberto; Riera, Lluı́s

doi:10.1007/s00345-020-03269-x

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…The number of kidney recipients with poor vascular conditions is expected to increase 2 ; therefore, OKTx may become more frequent. Furthermore, to minimize the invasiveness of open OKTx, robot‐assisted OKTx may also become possible 11 …”

Section: Discussionmentioning

confidence: 99%

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Orthotopic kidney transplantation from a living renal donor after interventional therapy for bilateral arteriosclerosis obliterans of the iliac arteries: A case report and literature review

Ohyama,

Sasaki,

Minamisono

et al. 2023

IJU Case Reports

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IntroductionOrthotopic kidney transplantation is an option when heterotopic kidney transplantation into the iliac fossa is inappropriate. We report a case of orthotopic kidney transplantation following stenting of both external iliac arteries to treat arteriosclerosis obliterans.Case presentationA 56‐year‐old woman on hemodialysis for end‐stage kidney disease underwent living‐donor kidney transplantation. Desensitization therapy was administered because of her history of sensitization by pregnancy. Stents had been placed previously in both external iliac arteries. The left kidney was removed via an oblique lumbar incision. The two graft arteries were conjoined and anastomosed to the native renal artery end‐to‐end. The urinary tract was reconstructed by uretero‐ureterostomy with ureteral stent placement. Renal function improved promptly after surgery.ConclusionPreoperative imaging of vascular anatomy is important for successful orthotopic kidney transplantation in patients who have previously undergone stenting of both external iliac arteries for arteriosclerosis obliterans.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, to minimize the invasiveness of open OKTx, robot‐assisted OKTx may also become possible. 11 …”

Section: Discussionmentioning

confidence: 99%

Orthotopic kidney transplantation from a living renal donor after interventional therapy for bilateral arteriosclerosis obliterans of the iliac arteries: A case report and literature review

Ohyama,

Sasaki,

Minamisono

et al. 2023

IJU Case Reports

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“…Oberholzer et al included patients with previous kidney transplantation or high risk of rejection [6]. It has also been demonstrated feasible the performance of simultaneous pancreas/kidney transplants, dual-kidney transplantation, or orthotopic kidney transplantation [32][33][34]. The most important challenges pertain the implementation of RAKT in deceased donor programs and the inclusion of patients affected by severe iliac artery atherosclerosis.…”

Section: Expanding Indications For Raktmentioning

confidence: 99%

Living Donor Robot-Assisted Kidney Transplantation: a New Standard of Care?

et al. 2021

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Purpose of Review Robot-assisted kidney transplantation (RAKT) has the potential to combine the advantages of minimally invasive surgery with the best renal replacement treatment. Over the last decade, the results were encouraging, as surgical and functional outcomes seem optimal in living donation. Recent studies focused on the comparison with open kidney transplantation (OKT), special situations such as obese patients or multiple vessels grafts and optimization of the technique to increase its surgical indications. Recent Findings Relative to OKT, RAKT has longer rewarming time and operative time, but lower intraoperative blood loss. Wound-related events and postoperative pain decrease with robotic technique. This has been also demonstrated in obese patients, where RAKT may be particularly beneficial. No significant difference was found in graft function, graft survival, and patient survival with RAKT and OKT in short-and mid-term follow-up. A multiple vessels graft should not be considered a contraindication to robotic surgery. Intracorporeal cooling systems for regional hypothermia have not been applied in RAKT yet. Future challenges will be the inclusion of patients with atheromatous iliac arteries and transplantation programs for deceased donors. Summary A randomized-controlled trial is needed to definitively confirm the findings of retrospective and prospective cohort studies. The implementation of the procedure in more centers depends on broader indications, which might ultimately decrease procedure-related costs. To guarantee the applicability of RAKT from deceased donors, it is fundamental to optimize the graft cooling systems and to include recipients with atheromatous iliac arteries.

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“…It is hoped that the development of laparoscopic techniques may provide an opportunity for improved orthotopic kidney transplantation. The application of LOKT has been reported in the literature and shows promise (6)(7)(8)(9)(10), and one case of orthotopic robot-assisted kidney transplantation has recently been reported (11). LOKT requires not only reliable intraoperative cooling measures to ensure the hypothermia and good function of the transplanted kidney, but also reliable vascular anastomosis techniques to ensure the anastomosis quality of the transplanted kidney vascular and good blood supply.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Orthotopic Kidney Transplantation in Swine: A Novel Vascular Prop Device for Venous Anastomoses

et al. 2021

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Objective: To investigate the safety and efficacy of a vascular prop device for laparoscopic orthotopic kidney transplantation (LOKT) in swine.Material and Methods: Twenty swine were randomly divided into two groups. A vascular prop device was used in the observation (VP) group, and the vein beltization technique was used in the control (VB) group. The right kidney, as a donor graft, was laparoscopically transplanted to the location of the left kidney after a left nephrectomy. Data on the operative time, venous anastomotic time, vein stenosis, etc., and the survival of the swine in the two groups were recorded.Results: The mean transplant operative time, the mean cold ischemia time, and the venous anastomotic times in the VP group were significantly shorter than those in the VB group. Seven swine in the VP group and three swine in the VB group survived for 7 days. Autopsy results showed the occurrence of one artery stenosis and one vein stenosis in the VP group and one artery stenosis and five vein stenoses in the VB group. The median survival time was 6.25 days for the swine in the VP group and 4.40 days for those in the VB group.Conclusions: The vascular prop device is safe and feasible for LOKT in swine and may accelerate venous anastomosis and ensure the quality of venous anastomotic stoma.

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Orthotopic robot-assisted kidney transplantation: first case report

Cited by 7 publications

References 10 publications

Orthotopic kidney transplantation from a living renal donor after interventional therapy for bilateral arteriosclerosis obliterans of the iliac arteries: A case report and literature review

Orthotopic kidney transplantation from a living renal donor after interventional therapy for bilateral arteriosclerosis obliterans of the iliac arteries: A case report and literature review

Living Donor Robot-Assisted Kidney Transplantation: a New Standard of Care?

Laparoscopic Orthotopic Kidney Transplantation in Swine: A Novel Vascular Prop Device for Venous Anastomoses

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