A comparison of robotic and open living donor kidney transplantation -The minimally invasive option and its outcomes

Background: Robotic assisted kidney transplantation (RAKT) has become a feasible option in field of transplantation. We have been routinely performing this technique in living donor kidney transplant with excellent outcomes. Here, we compare our results with our open living donor kidney transplants (OKT). Methods: From 2013 to 2016, a total of 96 OKTs and 25 RAKTs have been performed at a tertiary care center. Pre-operative characteristics, operative parameters and post-operative patient outcomes were analyzed. Results: The technique of RAKT included proper positioning, placement of a Gellpoint-port and 3 other ports followed by intraperitoneal kidney implantation. Two patients had to be converted to open because of technical complications, while one was aborted due to poor insufflation. The comparison between RAKT and OKT is outlined in Table 1. RAKT offered lower blood loss and cold ischemia time, while warm ischemia time was higher. There was no increased incidence of delayed graft function, while post-operative pain and return to ambulation was similar to OKT. There was lower incidence of wound related complications in RAKT. Patient and graft survival at 1 year was 100% for both. Conclusion: Robotic kidney transplantation offers minimally-invasive option with equivalent outcomes to open kidney transplants. In obese patients, it is technically easier to perform. We believe that beyond the learning curve, robotic kidney transplant can provide a minimally invasive option which will eventually reduce overall complications while maintaining great renal outcomes