Alessandro Giacomoni1, Stefano Di Sandro2, Andrea Lauterio1, Giacomo Concone3, Vincenzo Buscemi3, Ornella Rossetti1, Luciano De Carlis1. 1. Department of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy. 2. Department of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Department of Surgical Sciences, University of Pavia, Pavia, Italy; Department of Experimental Medicine, University of Pavia, Pavia, Italy. Electronic address: stefano.disandro@ospedaleniguarda.it. 3. Department of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Department of Surgical Sciences, University of Pavia, Pavia, Italy.
Abstract
BACKGROUND: As compared with traditional laparoscopy, robotic-assisted surgery provides better EndoWrist instruments and three-dimensional visualization of the operative field. Studies published so far indicate that living donor nephrectomy using the robot-assisted technique is safe, feasible, and provides remarkable advantages for the patients. METHODS: From 5 papers reporting detailed descriptions of surgical technique for robotic assisted nephrectomy (RAN) in living donor kidney transplantation, we have gathered information about the surgical techniques as well as about patients' intra- and postoperative outcome. Data from these articles were analyzed together with the data from our own experience (33 cases) so that the total number of analyzed cases was 292. RESULTS: In the analyzed populations, no case of donor death occurred, and no case developed complication above grade 2 of Clavien score. Perioperative complications occurred in 37 of the 292 patients (12.6%). Accidental acute hemorrhage occurred in 5 of the 292 cases (1.7%). The average overall intraoperative blood loss was 67.8 mL (range 10 to 1,500). The average warm ischemia time was 3.5 minutes (range .58 to 7.6). Conversion to the open technique occurred in only 4 cases (1.3%). The average overall operative time was 192 minutes (range 60 to 400). The average length of the hospital stay was 2.7 days (range 1 to 10). CONCLUSIONS: Safety and feasibility of RAN are pointed out in all the reviewed article, both as hand-assisted and as totally robotic technique. RAN appears to be significantly easier for the surgeons and the results are comparable with the ones obtained with the pure laparoscopic technique.
BACKGROUND: As compared with traditional laparoscopy, robotic-assisted surgery provides better EndoWrist instruments and three-dimensional visualization of the operative field. Studies published so far indicate that living donor nephrectomy using the robot-assisted technique is safe, feasible, and provides remarkable advantages for the patients. METHODS: From 5 papers reporting detailed descriptions of surgical technique for robotic assisted nephrectomy (RAN) in living donor kidney transplantation, we have gathered information about the surgical techniques as well as about patients' intra- and postoperative outcome. Data from these articles were analyzed together with the data from our own experience (33 cases) so that the total number of analyzed cases was 292. RESULTS: In the analyzed populations, no case of donordeath occurred, and no case developed complication above grade 2 of Clavien score. Perioperative complications occurred in 37 of the 292 patients (12.6%). Accidental acute hemorrhage occurred in 5 of the 292 cases (1.7%). The average overall intraoperative blood loss was 67.8 mL (range 10 to 1,500). The average warm ischemia time was 3.5 minutes (range .58 to 7.6). Conversion to the open technique occurred in only 4 cases (1.3%). The average overall operative time was 192 minutes (range 60 to 400). The average length of the hospital stay was 2.7 days (range 1 to 10). CONCLUSIONS: Safety and feasibility of RAN are pointed out in all the reviewed article, both as hand-assisted and as totally robotic technique. RAN appears to be significantly easier for the surgeons and the results are comparable with the ones obtained with the pure laparoscopic technique.
Authors: Anthony Yang; Naman Barman; Edward Chin; Daniel Herron; Antonios Arvelakis; Dianne LaPointe Rudow; Sander S Florman; Michael A Palese Journal: J Robot Surg Date: 2017-08-31
Authors: Maximilian Brunotte; Sebastian Rademacher; Justine Weber; Elisabeth Sucher; Andri Lederer; Hans-Michael Hau; Jens-Uwe Stolzenburg; Daniel Seehofer; Robert Sucher Journal: Ann Transl Med Date: 2020-03