title: Robotic surgery rapidly and successfully implemented in a high volume laparoscopic center on living kidney donation.
abstract: BACKGROUND
  It is important to minimize risks associated with live donor nephrectomy. In this study we evaluated the results of left-sided robot-assisted donor nephrectomies in comparison with standard techniques.
  
  
  METHODS
  Data on perioperative results, kidney function, and recipient and graft survival were collected. All left-sided laparoscopic and hand-assisted procedures were selected as control groups.
  
  
  RESULTS
  Fifty-nine robot-assisted procedures were performed by two surgeons. Operative time was significantly longer in the robot-assisted group compared with both control groups. However, it decreased significantly during procedures 40-59 compared with procedures 20-39 (P = 0.014) to median 172.5 (114.0-242.0) min. One conversion to the open approach occurred in the robot group due to a bleeding of the renal artery stump. No difference was found between all techniques at 3 months post-donation.
  
  
  CONCLUSIONS
  Left-sided robot-assisted donor nephrectomy is feasible with over time a significant decrease in operative time with good outcomes for donor and recipient. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Janki
authors.affiliation: Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: K W J
authors.initials: KWJ
authors.lastname: Klop
authors.affiliation: Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Hagen
authors.affiliation: Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Terkivatan
authors.affiliation: Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M G H
authors.initials: MGH
authors.lastname: Betjes
authors.affiliation: Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: T C K
authors.initials: TCK
authors.lastname: Tran
authors.affiliation: Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J N M
authors.initials: JNM
authors.lastname: Ijzermans
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control; D006085:Graft Survival; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data*; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014600:Utilization Review; D055815:Young Adult
keywords: living donors; minimal invasive surgical procedures; nephrectomy; outcome assessment; prospective studies; robotic surgical procedures