title: Current perspectives on laparoscopic robot-assisted pancreas and pancreas-kidney transplantation.
abstract: Pancreas transplant recipients continue to suffer high surgical morbidity. Current robotic technology provides a unique opportunity to test whether laparoscopy can improve the post-operative course of pancreas transplantation (PT). Current knowledge on robotic pancreas and renal transplantation was reviewed to determine feasibility and safety of robotic PT. Information available from literature was included in this review, together with personal experience including three PT, and two renal allotransplants. As of April 2011, the relevant literature provides two case reports on robotic renal transplantation. The author's experience consists of one further renal allotransplantation, two solitary PT, and one simultaneous pancreas-kidney transplantation. Information obtained at international conferences include several other renal allotransplants, but no additional PT. Preliminary data show that PT is feasible laparoscopically under robotic assistance, but raises concerns regarding the effects of increased warm ischemia time on graft viability. Indeed, during construction of vascular anastomoses, graft temperature progressively increases, since maintenance of a stable graft temperature is difficult to achieve laparoscopically. There is no proof that progressive graft warming produces actual damage to transplanted organs, unless exceedingly long. However, this important question is likely to elicit a vibrant discussion in the transplant community.
authors: Division of General and Transplant Surgery, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy. u.boggi@med.unipi.it
authors: Ugo
authors: U
authors: Boggi
authors: Stefano
authors: S
authors: Signori
authors: Fabio
authors: F
authors: Vistoli
authors: Gabriella
authors: G
authors: Amorese
authors: Giovanni
authors: G
authors: Consani
authors: Nelide
authors: N
authors: De Lio
authors: Vittorio
authors: V
authors: Perrone
authors: Chiara
authors: C
authors: Croce
authors: Piero
authors: P
authors: Marchetti
authors: Diego
authors: D
authors: Cantarovich
authors: Franco
authors: F
authors: Mosca
mesh_terms: D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods* / Q000639:trends*; D010179:Pancreas / Q000098:blood supply; D016035:Pancreas Transplantation / Q000295:instrumentation / Q000379:methods*; D012371:Robotics; D016896:Treatment Outcome