title: Complete robotic-assistance during laparoscopic living donor nephrectomies: an evaluation of 38 procedures at a single site.
abstract: 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.
authors.affiliation: Department of Urology, University Hospital of Nancy, 54511 Vandoeuvre-les-Nancy, France. j.hubert@chu-nancy.fr
authors.forename: Jacques
authors.initials: J
authors.lastname: Hubert
authors.forename: Edith
authors.initials: E
authors.lastname: Renoult
authors.forename: Eric
authors.initials: E
authors.lastname: Mourey
authors.forename: Luc
authors.initials: L
authors.lastname: Frimat
authors.forename: Luc
authors.initials: L
authors.lastname: Cormier
authors.forename: Michèle
authors.initials: M
authors.lastname: Kessler
mesh_terms: 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
chemical_list: D003404:Creatinine