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Robotic-assisted vs. laparoscopic donor nephrectomy: a retrospective comparison of perioperative course and postoperative outcome after 1 year

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Abstract

Safety is of utmost importance in live donor nephrectomies. In this study, we describe our initial experience with robot-assisted laparoscopic donor nephrectomy (RDN) in comparison with the standard laparoscopic donor nephrectomy (LDN). We retrospectively reviewed 95 patients who either underwent RDN or LDN performed by a single surgeon from 2011 to 2016 at a tertiary institution. Donor perioperative course and postoperative outcome along with recipient outcomes were compared. Of the 95 cases, 73 were classified as LDN and 22 were classified as RDN. There were no significant differences between the two groups in age, sex, BMI, race, and ASA status. Operative times (p < 0.001) were longer in the RDN group, but eventually approached LDN times. Warm ischemia (p = 0.002) and extraction times (p = 0.05) were also longer in the RDN cohort. The donor length of hospital stay, complication rates, and postoperative change in eGFR from baseline were similar in both cohorts up to 1 year. Recipient outcomes, including delayed graft function, graft failure, and renal function up to 1 year, were also comparable. In this study, we compared the longest postoperative course so far in both donors and recipients between RDN and LDN. Up to 1 year, RDN does not negatively impact outcomes. Proficiency with RDN also quickly improved to match LDN, making it a suitable procedure for newer surgeons.

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Abbreviations

ASA:

American society of anesthesiologists

BMI:

Body mass index

eGFR:

Estimated glomerular filtration rate

IRB:

Institutional review board

LDN:

Laparoscopic donor nephrectomy

MDRD:

Modification of diet in renal disease

RDN:

Robot-assisted laparoscopic donor nephrectomy

WIT:

Warm ischemia time

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Authors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1272, New York, NY, 10022, USA

    Anthony Yang, Naman Barman & Michael A. Palese

  2. Department of Surgery, Mount Sinai Medical Center, New York, NY, USA

    Edward Chin & Daniel Herron

  3. Mount Sinai Hospital, Recanati/Miller Transplantation Institute, New York, NY, USA

    Antonios Arvelakis, Dianne LaPointe Rudow & Sander S. Florman

Authors
  1. Anthony Yang
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  2. Naman Barman
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  3. Edward Chin
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  4. Daniel Herron
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  5. Antonios Arvelakis
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  6. Dianne LaPointe Rudow
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  7. Sander S. Florman
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  8. Michael A. Palese
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Contributions

Anthony Yang-author of the manuscript contributed to data collection, statistical analysis, and manuscript review. Naman Barman-contributed to study design, data collection, and manuscript review. Edward Chin-contributed to manuscript review. Daniel Herron contributed to manuscript review. Antonios Arvelakis contributed to manuscript review. Dianne LaPointe Rudow contributed to data collection and manuscript review. Sander S. Florman contributed to manuscript review. Michael A. Palese, Principal Investigator conducted the donor nephrectomies and contributed to study design and manuscript review.

Corresponding author

Correspondence to Michael A. Palese.

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Funding

This study was not funded.

Conflict of interest

All authors (Anthony Yang, Naman Barman, Edward Chin, Daniel Herron, Antonios Arvelakis, Dianne LaPointe Rudow, Sander S. Florman, and Michael A. Palese) declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board at the Icahn School of Medicine at Mount Sinai and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

As determined by the institutional review board, informed consent was not required.

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Yang, A., Barman, N., Chin, E. et al. Robotic-assisted vs. laparoscopic donor nephrectomy: a retrospective comparison of perioperative course and postoperative outcome after 1 year. J Robotic Surg 12, 343–350 (2018). https://doi.org/10.1007/s11701-017-0741-x

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  • DOI: https://doi.org/10.1007/s11701-017-0741-x

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