Korean J Transplant.  2022 Mar;36(1):61-66. 10.4285/kjt.21.0023.

The first robotic kidney transplantation in Korea: a case report

Affiliations
  • 1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
  • 3Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
  • 4Department of Urology, Yonsei University College of Medicine, Seoul, Korea

Abstract

Minimally invasive surgery reduces perioperative pain and morbidity, facilitating rapid recovery. However, the field of kidney transplantation has lagged in this regard, its customary open surgical techniques going nearly unchanged until recently. Robotic kidney transplantation (RKT) is a novel and welcomed innovation yielding good surgical outcomes. In Korea, the first RKT performed (November 2019) involved a 30-year-old man (body mass index, 22 kg/m2 ) with end-stage hypertensive nephrosclerosis. A left donor kidney from his 28-year-old sister was successfully transplanted using the daVinci Robotic Surgical System. Transperitoneal regional hypothermia (Vattikuti Urology Institute-Medanta technique) was also implemented across the main periumbilical incision (up to 6 cm). Total operative time was 260 minutes (cold ischemia, 34 minutes; rewarming, 54 minutes), with 50 mL of blood loss. There was immediate graft function, unencumbered by surgical complications (e.g., postoperative bleeding, leakage, or lymphocele). The patient was discharged on postoperative day 8, with serum creatinine at 1.27 mg/dL. RKT with regional hypothermia may be a viable, minimally invasive intervention that is safe and effective in select patients, showing good surgical results.

Keyword

Robotic; Kidney transplantation; Regional hypothermia; Case report

Figure

  • Fig. 1 Trocar positioning.

  • Fig. 2 Peritoneal flap.

  • Fig. 3 Venous anastomosis.

  • Fig. 4 Arterial anastomosis.

  • Fig. 5 Ureteroneocystostomy.

  • Fig. 6 Postoperative wound.


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