Comparison of Single-Port Robotic Donor Nephrectomy and Laparoscopic Donor Nephrectomy

Michael A. Palese, Chih Peng Chin, Evan B. Garden, Benjamin Eilender, Micah Levy, Krishna T. Ravivarapu, Daniel Wang, Hannah Freid, Osama Al-Alao, Joseph Sewell Araya, Dianne LaPointe-Rudow, Daniel Herron, Edward Chin, Antonios Arvelakis, Ron Shapiro, Francisca Larenas, Sander S. Florman

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare the intra- and postoperative outcomes of single-port robotic donor nephrectomies (SP RDNs) and laparoscopic donor nephrectomies (LDNs). Materials and Methods: We retrospectively reviewed our institutional database for patients who received LDN or SP RDN between September 2020 and December 2022. Donor baseline characteristics, intraoperative outcomes, postoperative outcomes, and recipient renal function were extracted and compared between LDN and SP RDN. SP RDN learning curve analysis based on operative time and graft extraction time was performed using cumulative sum analysis. Results: One hundred forty-four patients underwent LDN and 32 patients underwent SP RDN. LDN and SP RDN had similar operative times (LDN: 190.3 - 28.0 minutes, SP RDN: 194.5 - 35.1 minutes, p = 0.3253). SP RDN patients had significantly greater extraction times (LDN: 83.2 - 40.3 seconds, SP RDN: 204.1 - 52.2 seconds, p < 0.0001) and warm ischemia times (LDN: 145.1 - 61.7 seconds, SP RDN: 275.4 - 65.6 seconds, p < 0.0001). There were no differences in patient subjective pain scores, inpatient opioid usage, or Clavien- Dindo II+ complications. Short- and medium-term postoperative donor and recipient renal function were also similar between the groups. SP RDN graft extraction time and total operative time learning curves were achieved at case 27 and 13, respectively. Conclusion: SP RDN is a safe and feasible alternative to LDN that minimizes postoperative abdominal incisional scars and has a short learning curve. Future randomized prospective clinical trials are needed to confirm the findings of this study and to identify other potential benefits and drawbacks of SP RDNs.

Original languageEnglish
Pages (from-to)136-141
Number of pages6
JournalJournal of Endourology
Volume38
Issue number2
DOIs
StatePublished - 1 Feb 2024

Keywords

  • laparoscopy approach
  • renal transplant or donor nephrectomy
  • robotics

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