Glickman Urological & Kidney Institute, Cleveland Clinic Main Campus
Introduction: We introduced the single-port robot-assisted kidney transplantation (KTP) using the da Vinci SP platform in 2019. Herein, we aimed to compare the perioperative and follow-up outcomes of the initial series of patients who underwent this procedure with the standard open KTP.
Methods: We compared a prospective cohort of 12 patients who underwent SP robotic KTP from Oct 2019 to Oct 2021 with a retrospective cohort of 12 matched patients who had open KTP at our institute. Patients were matched for donor type, the kidney donor profile index (KDPI) in deceased donors, recipient age, and history of diabetes. Perioperative data were retrieved from our institutional review board (IRB) approved database. Normality of data was tested with the Kolmogorov-Smirnov test when indicated. The comparison of normal data was performed using a T-test. Comparison of percentages was performed using the "N-1" Chi-squared test.
Results: Baseline characteristics and perioperative data of these patients are presented in table 1. No patients in SP arm were converted to open surgery. Mean (SD) revascularization time in SP and open arms were 72.75 (11.93) and 36.25 (9.39) minutes respectively (P < 0.0001). There were no intra or postoperative complications greater than Clavien grade 2 in either group. The morphine milligram equivalents (MME) score during admission was 44.91 (40.15) in SP and 149.16 (119.70) in open groups (P = 0.0091). 6-, and 12-month graft and patient survival were 100% in both arms. There was no significant difference in mean creatinine level at 1, 6, and 12 months between SP vs. open group. There were no vascular or surgical complications during follow-up in either arm.
Conclusions: Single port robotic kidney transplantation offers a minimally invasive approach with similar safety and allograft function compared to open kidney transplantation with the added benefit of less postoperative narcotics requirement. Larger series are required in this setting.
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