title: Robotic-assisted kidney transplantation: our first case.
abstract: OBJECTIVE
  Kidney transplantation is the preferred treatment for patients with end-stage renal disease. In order to reduce the morbidity of the open surgery, a robotic-assisted approach has been recently introduced. According to the published literature, the robotic surgery allows the performance of kidney transplantation under optimal operative conditions while maintaining the safety and the functional results of the open approach.
  
  
  METHODS
  We present the case of a mother donating to her daughter affected by end-stage renal disease (ESRD) due to Alport disease (creatinine: 353 umol/l; GFR: 13 ml/min per 1.73 m(2)).
  
  
  RESULTS
  A robotic-assisted kidney transplant (RAKT) was successfully performed. Surgical time was 120 min with 53 min for vascular suture. The estimated blood loss was <50 cc. The kidney started to produce urine intra-operatively with a rate of 250 cc/h, which remained constant over the next hours. During the first postoperative day, the patient was ambulating and started oral intake. Pain was minimal, and no analgesia was required after 48 h. Serum creatinine improved progressively to 89 umol/l on postoperative day 3. No surgical complications were recorded, and the patient was sent home on postoperative day 5.
  
  
  CONCLUSIONS
  We present the first Spanish transperitoneal pure RAKT from a living-related donor. We believe this is the second pure robotic-assisted kidney transplantation case performed in Europe. We believe that the potential advantages of RAKT are related to the quality of the vascular anastomosis, the possible lower complication rate and the shorter recovery of the recipients.
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain. albbred@hotmail.com.
authors: A
authors: A
authors: Breda
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors: L
authors: L
authors: Gausa
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.|Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
authors: A
authors: A
authors: Territo
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors: J M
authors: JM
authors: López-Martínez
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors: O
authors: O
authors: Rodríguez-Faba
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors: J
authors: J
authors: Caffaratti
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors: J Ponce
authors: JP
authors: de León
authors: Department of Nephrology, Fundaciò Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors: L
authors: L
authors: Guirado
authors: Department of Urology, Fundaciò Puigvert, Autonoma University of Barcelona, Calle Cartagena 340-350, 08025, Barcelona, Spain.
authors: H
authors: H
authors: Villavicencio
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012371:Robotics / Q000379:methods*; D009927:Tissue and Organ Procurement
keywords: Kidney transplantation; Living-donor nephrectomy; Minimally invasive surgery; Robotic-assisted