title: Robotic kidney transplantation: one year after the beginning.
abstract: BACKGROUND
  Kidney transplantation (KT) is the preferred treatment for patients with end-stage renal disease (ESRD). To reduce the morbidity of the open surgery, a robotic-assisted approach has been recently introduced. Our aim is to evaluate surgical and functional results on 17 cases of robotic-assisted kidney transplantation (RAKT) performed at the same institution.
  
  
  METHODS
  From July 2015 to June 2016, we performed 17 cases of RAKT from living donors in pre-emptive patients, who underwent laparoscopic nephrectomy. A prospective pilot study was made at Fundació Puigvert (Barcelona), evaluating functional and surgical outcomes. In this series, we considered the functional results, surgical outcomes and complications rates.
  
  
  RESULTS
  Seventeen patients successfully underwent RAKT, in particular surgical console time was 181 min (150-200) with vascular suture time 42 min (32-48), and estimated blood loss <70 ml. Overall ischemia time was 98.9 min (84-140). No patient was converted to open transplantation. No major surgical intra-operative complications were observed. The mean post-operative serum creatinine level 160 μmol/L (81-479). We reported a case of delayed graft function (DGF), one case of graft arterial thrombosis and one case of intraperitoneal hematoma. No anastomosis revision and wounds infections occurred.
  
  
  CONCLUSIONS
  RAKT with regional hypothermia appears to be a safe surgical procedure in a properly selected group of patients. 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.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain. albbred@gmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Breda
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Angelo
authors.initials: A
authors.lastname: Territo
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Gausa
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Rodríguez-Faba
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Caffaratti
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Javier Ponce
authors.initials: JP
authors.lastname: de León
authors.affiliation: Department of Nephrology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Guirado
authors.affiliation: Department of Nephrology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Facundo
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Marco
authors.initials: M
authors.lastname: Guazzieri
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.|Department of Urology, U.L.S.S. 15 "Alta Padovana", Camposampiero Hospital, Camposampiero, Padua, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Guttilla
authors.affiliation: Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
authors.forename: Humberto
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011446:Prospective Studies; D020127:Recovery of Function; D065287:Robotic Surgical Procedures; D013030:Spain; D016896:Treatment Outcome
keywords: Kidney transplantation; Regional hypothermia; Robot-assisted kidney transplantation; Robotic surgery; Vascular anastomosis