Robotic surgery rapidly and successfully implemented in a high volume laparoscopic center on living kidney donation

Janki, Shiromani; Klop, Karel; Hagen, Sander M.; Terkivatan, Türkan; Betjes, Michiel G. H.; Tran, T. C. K.; IJzermans, Jan N.M.

doi:10.1002/rcs.1743

Cited by 28 publications

(42 citation statements)

References 37 publications

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“…Janki et al [9] showed a significant improvement in total operative time after 60 RADNs performed, indicating the importance of the learning curve in RADN.…”

Section: Resultsmentioning

confidence: 99%

“…The series presented by Janki et al [9] showed that left-sided RADN is safe and feasible with good outcomes for donor, recipient, and graft survival after 3 months of follow-up. The RADN procedure might take longer; however, 3D imaging, better instrument movement, and comfort are gained.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, Janki et al [9] compared RADN to hand-assisted retroperitoneoscopic donor nephrectomy (HARP) and standard laparoscopic kidney (LDN) procurement. There was a significantly longer median total operative time with RADN compared to both LDN and HARP.…”

Section: Resultsmentioning

confidence: 99%

“…Previous research has clearly shown both superior survival of kidney grafts from live donors after transplantation and fewer postoperative complications [9,10].…”

Section: Live Kidney Donationmentioning

confidence: 99%

“…While the conventional surgical approach with a mini-incision for open live donor nephrectomy has been shown to significantly reduce morbidity compared to historic open approaches [11][12][13][14], laparoscopic transperitoneal donor nephrectomy has become standard procedure for the procurement of live donor kidneys due to better visibility of the operative field in many centers [9] being associated with a short hospital stay, less pain, and fast recovery after surgery in some studies [15,16].…”

Section: Live Kidney Donationmentioning

confidence: 99%

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Robot-Assisted Transplant Surgery - Vision or Reality A Comprehensive Review

Stiegler¹,

Schemmer²

2018

Visc Med

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Minimally invasive surgery is standard procedure for many operations. Further refinements include the introduction of robotic surgery which is still an emerging field especially in laparoscopic surgery. Since the successful introduction of the da Vinci Robotic Surgical System, the robotic approach in organ transplantation has become of great interest in both the live donor organ retrieval and the recipient operation. Robotic surgery for kidney, liver, and pancreas transplantation is feasible. Over 700 donor nephrectomies and 100 kidney transplantations have been performed already, and robotic surgery is standard in a small number of pioneer centers; however, larger series and most importantly randomized controlled trials for the highest evidence are needed. Longer warm ischemia time and higher costs limit these procedures at the moment.

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“…Janki et al [9] showed a significant improvement in total operative time after 60 RADNs performed, indicating the importance of the learning curve in RADN.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Previous research has clearly shown both superior survival of kidney grafts from live donors after transplantation and fewer postoperative complications [9,10].…”

Section: Live Kidney Donationmentioning

confidence: 99%

Section: Live Kidney Donationmentioning

confidence: 99%

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Robot-Assisted Transplant Surgery - Vision or Reality A Comprehensive Review

Stiegler¹,

Schemmer²

2018

Visc Med

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Effective and safe implementation of robot‐assisted donor nephrectomy by experienced laparoscopic surgeons

van de Geijn,

Janki,

de Vries

et al. 2024

World j. surg.

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BackgroundIn June 2021, the first robot‐assisted donor nephrectomy (RADN) was performed at the Leiden University Medical Center (LUMC), the Netherlands. The goal of this study was to investigate whether this procedure has been implemented safely and efficiently.MethodsRADN was retrospectively compared to laparoscopic donor nephrectomy (LDN) performed during the same time period (June 2021 until November 2022). Patients were assigned to RADN depending on the availability of the da Vinci robot and surgical team. The studied endpoints were postoperative complications, operative time, estimated blood loss, warm ischemic time (WIT), and postoperative pain experience. For analysis, the Student's t‐test and Chi‐squared test were used for, respectively, continuous and categorical data.ResultsForty RADN were compared to 63 LDN. Total insufflation time was significantly longer in RADN compared to LDN (188 min (169–214) versus 172 min (144–194); p = 0.02). Additionally, WIT was also found to be significantly higher in the robot‐assisted group (04:54 min vs. 04:07 min; p < 0.01). No statistical differences were found in postoperative outcomes (eGFR of the recipient at 3‐month follow‐up, RADN 54.08 mL/min ±18.79 vs. LDN 56.41 mL/min ±16.82; p = 0.52), pain experience, and complication rate.ConclusionRADN was safely and efficiently implemented at the LUMC. It's results were not inferior to laparoscopic donor nephrectomy. Operative time and warm ischemic times were longer in RADN. This may relate to a learning curve effect. No clinically relevant effect on postoperative outcomes was observed.

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