Robotic Trans-Abdominal Transplant Nephrectomy for a Failed Renal Allograft

Abstract

Minimally invasive surgery for removal of a failed renal allograft has not previously been reported. Herein, we report the first robotic trans-abdominal transplant nephrectomy (TN). A 34-year-old male with Alport's syndrome lost function of his deceased donor allograft after 12 years and presented with fever, pain over his allograft and hematuria. The operation was performed intra-abdominally using the Da Vinci Robotic Surgical System with four trocars. The total operative time was 235 min and the estimated blood loss was less than 25 cm 3 . There were no peri-operative complications observed and the patient was discharged to home less than 24 h postoperatively. The utilization of robotic technology facilitated the successful performance of a minimally invasive, trans-abdominal TN.

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

“…Therefore, RAKT at the moment should be limited to obese patients who seem to clearly benefit from this method. Furthermore, besides transplantation, robot-assisted procedures have been described in KTx recipients for the management of surgical complications, such as cases of pyeloureterostomy for ureteral stricture [35], partial nephrectomy for the treatment of a renal mass in a transplanted kidney [36], transabdominal graft nephrectomy [37], and radical prostatectomy for prostate cancer treatment in kidney transplant recipients [38] with good results.…”

The use of robotic surgery in abdominal organ transplantation: A literature review

“…Robot‐assisted procedures have been described in recipients of open surgery kidney transplants for the management of surgical complications, such as cases of pyeloureterostomy for ureteral stricture, partial nephrectomy for the treatment of a renal mass in a transplanted kidney, trans‐abdominal graft nephrectomy, and radical prostatectomy for prostate cancer treatment in renal transplant recipients …”

“…Based on a global experience of only 12 cases, RS appears to be a safe surgical alternative to the standard open approach in the management of different conditions after KT. Robotic radical prostatectomy after KT will be increasingly undertaken, as has been the case in the non‐transplant population.…”

“…Robot-assisted procedures have been described in recipients of open surgery kidney transplants for the management of surgical complications, such as cases of pyeloureterostomy for ureteral stricture, 15 partial nephrectomy for the treatment of a renal mass in a transplanted kidney, 16 trans-abdominal graft nephrectomy, 17 and radical prostatectomy for prostate cancer treatment in renal transplant recipients. [18][19][20] Based on a global experience of only 12 cases, 15-20 RS appears to be a safe surgical alternative to the standard open approach in the management of different conditions after KT.…”

Pushing Boundaries: Robotic Nephrectomy of an Auto-transplanted Kidney for Recurrent Renal Cell Carcinoma

“…The advent of minimally invasive surgery has revolutionized patient-related postsurgical outcomes, including reduced pain, shortened length of stay, and improved cosmesis. While minimally invasive surgery has become the standard for numerous intra-abdominal and retroperitoneal procedures including partial and radical nephrectomy, there is only one published report of a robotic approach to transplant nephrectomy for a failed renal allograft [ 4 ]. To our knowledge, this approach has not been reported for an auto-transplant kidney.…”