Korean J Transplant.  2023 Sep;37(3):165-169. 10.4285/kjt.23.0022.

Minimally invasive recipient procedure in kidney transplantation

• Miura Y
• Nakafusa Y
• Yokota-Ikeda N
• Ota M
• Otomo N

• KMID: 2546474
• DOI: http://doi.org/10.4285/kjt.23.0022

Abstract

Background
There are several procedural variations for kidney transplant donors, including open, laparoscopic, hand-assisted, and robotic methods, with either an intra- abdominal or retroperitoneal approach. Conversely, fewer options are available for the recipient procedure. We introduce a method that involves a small incision, with the goal of being less invasive for recipients.
Methods
Our current method was introduced in April 2022. As of July 2023, we have completed 27 cases. We analyzed several factors in these 27 cases, including the size of the incision, rewarming time, anastomosis time, graft function, analgesic use, and complications.
Results
The average incision size was 73 mm. The time taken for anastomosis was 24. 1 minutes, while the rewarming time averaged 43.1 minutes. There were no instances of primary nonfunction. One case necessitated postoperative dialysis three times due to heart failure. Following stent removal, one patient developed grade 1 hydronephrosis. There was one instance of bleeding from the drain insertion site. Another case involved a clamp injury to the external iliac artery, which necessitated stent insertion on the fourth postoperative day. Compared to procedures performed using conventional methods, the use of analgesics was less in these cases.
Conclusions
Our minimally invasive technique, which involves a small incision, is a feasible alternative that could potentially be less invasive than traditional methods.

Keyword

Minimally invasive surgical procedures; Postsurgical pain; Recipient procedure; Small incision

Figure

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  Fig. 1 Skin incision: (A) conventional incision (B) small incision.

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  Fig. 2 Serum creatinine (Cr) levels before and after kidney transplantation. (A) Small incision group. (B) Conventional group. Each color of the graph corresponds each patient.

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