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.

Giacomoni, A., Di Sandro, S., Lauterio, A., Concone, G., Buscemi, V., Rossetti, O., et al. (2016). Robotic nephrectomy for living donation: Surgical technique and literature systematic review. THE AMERICAN JOURNAL OF SURGERY, 211(6), 1135-1142 [10.1016/j.amjsurg.2015.08.019].

Robotic nephrectomy for living donation: Surgical technique and literature systematic review

Lauterio, Andrea;De Carlis, Luciano
2016

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.
Articolo in rivista - Review Essay
Kidney transplantation; Living donation; Robotic-assisted nephrectomy; Systematic review;
Kidney transplantation; Living donation; Robotic-assisted nephrectomy; Systematic review; Adolescent; Adult; Blood Loss, Surgical; Female; Graft Rejection; Graft Survival; Humans; Kidney Transplantation; Length of Stay; Male; Middle Aged; Nephrectomy; Operative Time; Robotic Surgical Procedures; Survival Rate; Treatment Outcome; Young Adult; Living Donors; Patient Safety; Surgery
English
2016
211
6
1135
1142
none
Giacomoni, A., Di Sandro, S., Lauterio, A., Concone, G., Buscemi, V., Rossetti, O., et al. (2016). Robotic nephrectomy for living donation: Surgical technique and literature systematic review. THE AMERICAN JOURNAL OF SURGERY, 211(6), 1135-1142 [10.1016/j.amjsurg.2015.08.019].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/203692
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