Abstract
Objectives: The da Vinci SP® Surgical System received U.S. Food and Drug Administration approval for urolog-ical procedures in 2018. Here, we describe the first experience performing single-port robot-assisted donor nephrectomy (RADN) using the da Vinci SP® surgical system, present 90-day clinical outcomes, and discuss tips for operative success. Methods: Seven consecutive patients underwent single-port RADN at a single institution between September 1, 2020 and March 31, 2021. Surgery was performed through a single, 60 mm Pfannenstiel incision with a 12 mm periumbilical assistant port for suction and vascu-lar stapling. Donor characteristics, operative details, 90-day donor clinical outcomes, and recipient renal function were retrospectively evaluated. Results: Four female and three male patients successfully underwent single-port RADN without conversion to standard multiport or open approach. Six cases were left-sided. Estimated blood loss for each procedure was ≤ 50 mL. Mean operative time, warm ischemia time, and extraction time were 218.3 minutes (standard deviation [SD]: 16.3 minutes), 5 minutes 4 seconds (SD: 56 seconds), and 3 minutes 37 seconds (SD: 38 seconds). Mean pre-op-erative creatinine and estimated glomerular filtration rate were 0.79 mg/dL and 107.3 mL/min/1.73m2, respectively. At six week’s follow up, they were 1.22 mg/dL and 66.1 mL/min/1.73m2. Average pain score at 48 hours post-operatively was 1.7/10. There were no Clavien-Dindo grade ≥III complications within 90 days. All recipients experienced immediate and sustained return of renal function post-transplant. Conclusion: Single-port RADN is a technically feasible and safe procedure with the da Vinci SP® system and can confer acceptable functional and cosmetic outcomes. Future studies are needed to define long-term outcomes and compare with previously established techniques for donor nephrectomy.
Original language | English |
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Article number | e2021.00062 |
Journal | Journal of the Society of Laparoendoscopic Surgeons |
Volume | 25 |
Issue number | 4 |
DOIs | |
State | Published - 1 Oct 2021 |
Keywords
- Donor nephrectomy
- Living donor
- Robotic surgery
- Single-port
- Transplantation