Renal transplantation through a modified non-muscle-cutting Pfannenstiel incision

Kishore, TA; Shetty, Abijit; Tharun, BK; John, Eluvathingal Varghese; Bhat, Suresh

doi:10.1007/s11255-013-0608-7

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Patients without morbid obesity deserve well of minimally invasive renal transplantation in the retroperitoneum, where the risk of percutaneous renal biopsy was minimal [20,21]. However, patients of low BMI, as Keshore et al [22] reported to be 20 AE 2.9 kg/m 2 , might have incisions of 13 AE 1.7 cm in length allowing vascular anastomoses after placing the renal grafts in the retroperitoneal space. We would maintain that robotic assistance which provided relatively ample operation space and full range of sewing motion could benefit a renal transplant patient through an even smaller skin incision (7.7 AE 1.04 cm in our series).…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted renal transplantation in the retroperitoneum

et al. 2014

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SummaryMinimally invasive surgery for renal transplantation is still under development. We employed the robotic surgical system to perform renal transplantation with a minimally invasive wound. The operation was performed with a Gibson incision and two working ports. The space for the transplantation was created by retroperitoneal dissection with the robot lifting the abdominal wall. Vascular reconstruction was performed with two robotic needle drivers. We successfully performed robot-assisted renal transplantation in five female and five male patients with an average wound length of 7.7 AE 1.04 cm. Nine of the renal allografts functioned immediately, but one with prolonged warm ischemia during the live donor nephrectomy had delayed function. The average creatinine level and estimated glomerular filtration rate at discharge were 1.31 AE 0.31 mg/dl and 58.2 AE 8.1 ml/min, respectively. All the transplants are currently functioning at 6.9 AE 3.9 months after operations. In conclusion, with robot assistance, minimal invasive renal transplantation can be performed successfully in the retroperitoneum.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted renal transplantation in the retroperitoneum

et al. 2014

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“…Kidney transplantation (KT) stands as the foremost treatment for individuals with end-stage renal disease (ESRD), offering an enhanced quality of life and extended life expectancy when compared to dialysis 1 . Despite the heightened morbidity and increased risk of surgical site infection 2 , 3 , the open surgical approach has remained the standard procedure for KT since its inaugural success in 1954 4 . While minimally invasive surgical techniques in open kidney surgery have been suggested 5 and are employed in some clinical settings 6 , they aren’t suitable for ESRD patients with obesity.…”

Section: Introductionmentioning

confidence: 99%

“… 9 discovered that maintaining rewarming time under 50 min using the Vattikuti Urology Institute-Medanta Technique (VUIMT) can prevent any impairment of renal function. Although some high-volume centers have reported a median rewarming time of less than 50 min 2 , 10 , achieving this goal can be challenging and may require at least 35 cases 14 . Another strategy to mitigate the negative effects of rewarming is by keeping the graft at a lower temperature.…”

Section: Introductionmentioning

confidence: 99%

Continuous renal surface cooling technique (CSCT) in robotic-assisted kidney transplantation: technique and outcomes from a high-volume center: a prospective cohort study

Zhang,

Zeng,

Fan

et al. 2024

International Journal of Surgery

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Background: Robot-assisted kidney transplantation (RAKT) surgery is an advanced minimally invasive technique, albeit with extended surgical and kidney ischemia time. To safeguard kidney function, we have devised a continuous surface cooling method (CSCT) for intraoperative kidney cooling. Materials and Methods: Patients receiving RAKT were divided into CSCT group and conventional group. The CSCT is a custom-designed apparatus composed of a single-layer plastic bag, featuring an inflow and an outflow that create a closed circuit for the continuous flow of cooling saline. The conventional group utilized ice slush for kidney graft cooling (Vattikuti Urology Institute-Medanta Technique, VUIMT). Patients who underwent open renal transplantation during the same period were also included in the study. All patients were subject to a minimum 2-month follow-up. And 1:3 propensity score matching was used to minimize selection bias. Results: A total of 144 patients underwent CSCT, 47 underwent VUIMT, and 196 underwent open surgery were included in the study, while after matching, 129, 43, 129 patients were included in the three groups, respectively. The median follow-up time was 19 months. None of the patients experienced delayed graft function, patient mortality, or graft loss. After introducing the kidney into the abdominal cavity for 20 minutes, the surface temperature of the kidney in the CSCT group was notably lower compared to the VUIMT group (15.42±0.88 vs. 21.74±2.53°C, P=0.001). This temperature disparity became more pronounced at 65 minutes (19.74±1.61 vs. 29.82±1.63°C, P<0.001). At both 3 and 7 days post-transplantation, creatinine levels in the VUIMT group were significantly higher than those in the CSCT and open surgery groups (at 3 d, 244.13±45.61 vs. 182.51±55.47 in CSCT group, P<0.001, or vs. 182.77±61.32 in the open surgery group, P<0.001; at 7 d, 162.42±54.86 vs. 143.11±44.32 in the CSCT group, P<0.001, or vs. 135.23±45.27 in the open surgery group, P<0.001). No differences were observed in blood creatinine, estimated glomerular filtration rate, and perioperative complications between the CSCT and open surgery groups. Conclusion: The CSCT presents a significant advantage over the traditional VUIMT method in terms of kidney cooling and early postoperative kidney function preservation. Additional research is required to ascertain whether the CSCT can enhance the long-term prognosis of kidney transplant recipients.

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Kidney Transplant Surgery Techniques

Barański

2023

Kidney Transplantation

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Renal transplantation through a modified non-muscle-cutting Pfannenstiel incision

Abstract: In the era of minimally invasive surgery, MFI technique could challenge the role of laparoscopic and robotic surgery in renal transplantation. Our study shows that the technique is successful in carefully selected patients with low BMI.

Cited by 10 publications

References 11 publications

Robot-assisted renal transplantation in the retroperitoneum

Robot-assisted renal transplantation in the retroperitoneum

Continuous renal surface cooling technique (CSCT) in robotic-assisted kidney transplantation: technique and outcomes from a high-volume center: a prospective cohort study

Kidney Transplant Surgery Techniques

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