Robotic-assisted laparoscopic donor nephrectomy with transvaginal extraction of the kidney.
Transvaginal recovery of the kidney has recently been reported, in a donor who had previously undergone a hysterectomy, as a less-invasive approach to perform laparoscopic live-donor nephrectomy. Also, robotic-assisted laparoscopic kidney donation was suggested to enhance the surgeon's skills during renal dissection and to facilitate, in a different setting, the closure of the vaginal wall after a colpotomy. We report here the technique used for the first case of robotic-assisted laparoscopic live-donor nephrectomy with transvaginal extraction of the graft in a patient with the uterus in place. The procedure was carried out by a multidisciplinary team, including a gynecologist. Total operative time was 215 min with a robotic time of 95 min. Warm ischemia time was 3 min and 15 s. The kidney was pre-entrapped in a bag and extracted transvaginally. There was no intra- or postoperative complication. No infection was seen in the donor or in the recipient. The donor did not require postoperative analgesia and was discharged from the hospital 24 h after surgery. Our initial experience with the combination of robotic surgery and transvaginal extraction of the donated kidney appears to open a new opportunity to further minimize the trauma to selected donors.
Service of Surgery, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. andrea.pietrabissa@gmail.com
A
A
Pietrabissa
M
M
Abelli
A
A
Spinillo
M
M
Alessiani
S
S
Zonta
E
E
Ticozzelli
A
A
Peri
A
A
Dal Canton
P
P
Dionigi
D000328:Adult; D020884:Colpotomy; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012371:Robotics; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014621:Vagina