Complete robotic-assistance during laparoscopic living donor nephrectomies: an evaluation of 38 procedures at a single site.
OBJECTIVE
To evaluate our initial experience with entirely robot-assisted laparoscopic live donor (RALD) nephrectomies.


METHODS
From January 2002 to April 2006, we carried out 38 RALD nephrectomies at our institution, using four ports (three for the robotic arms and one for the assistant). The collateral veins were ligated, and the renal arteries and veins clipped, after completion of ureteral and renal dissection. The kidney was removed via a suprapubic Pfannenstiel incision. A complementary running suture was carried out on the arterial stump to secure the hemostasis.


RESULTS
Mean donor age was 43 years. All nephrectomies were carried out entirely laparoscopically, without complications and with minimal blood loss. Mean surgery time was 181 min. Average warm ischemia and cold ischemia times were 5.84 min and 180 min, respectively. Average donor hospital stay was 5.5 days. None of the transplant recipients had delayed graft function.


CONCLUSIONS
Robot-assisted laparoscopic live donor nephrectomy can be safely carried out. Robotics enhances the laparoscopist's skills, enables the surgeon to dissect meticulously and to prevent problematic bleeding more easily. Donor morbidity and hospitalization are reduced by the laparoscopic approach and the use of robotics allows the surgeon to work under better ergonomic conditions.
Hubert
Jacques
J
Department of Urology, University Hospital of Nancy, 54511 Vandoeuvre-les-Nancy, France. j.hubert@chu-nancy.fr
Renoult
Edith
E
Mourey
Eric
E
Frimat
Luc
L
Cormier
Luc
L
Kessler
Michèle
M
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D012371:Robotics
D003404:Creatinine