Early experience of robot assisted kidney transplantation
10.3760/cma.j.cn421203-20230319-00057
- VernacularTitle:经阴道机器人辅助肾移植1例报道及文献回顾
- Author:
Haohan ZHANG
1
;
Ming MA
;
Jiapei WU
;
Yu FAN
;
Tao LIN
;
Turun SONG
Author Information
1. 四川大学华西医院泌尿外科泌尿外科研究所器官移植中心，成都 610047
- Keywords:
Kidney transplantation;
Minimally invasive surgery;
Robot-assisted technology;
Natural orifice transluminal endoscopic surgery
- From:
Chinese Journal of Organ Transplantation
2024;45(2):104-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Exploring the surgical method and safety of robot assisted kidney transplantation (RAKT) with a kidney implanted through the vagina, currently there is no such surgery in China.Method:Retrospective analysis of the data of a 44-year-old postpartum woman with stage 5 chronic kidney disease admitted to the kidney transplantation ward of West China Hospital, Sichuan University on June 28, 2021. RAKT with a kidney inserted through the vagina was performed on the recipient. The transplanted kidney was cooled using continuous surface cooling technology (CSCT) using ice physiological saline. The recipient was followed up for 3 months after surgery. In addition, we searched the Wanfang database, China National Knowledge Infrastructure, VIP database, China Biomedical Literature Service System, PubMed, Embase, and Central databases. The Chinese search keywords were "robot kidney transplantation" and "vagina", while the English search keywords were "kidney transplantation" and "robot" and "vacuum". The literature was published from June 1990 to June 2022, and a detailed summary of all published cases was provided.Result:a perineal approach was used to open the posterior fornix of the vagina and the graft was successfully implanted. The surgery was successfully completed, with a total duration of 250 minutes, vascular anastomosis time of 45 minutes, and warm ischemia time of 63 minutes. The recipient recovered smoothly without vaginal pain and postoperative pain relief; There was also no abdominal infection. Using CSCT, the surface temperature of the graft was maintained at 10~16 ℃ during anastomosis. After literature review, a total of 12 cases of renal RAKT implantation through vagina have been reported. All cases were successful, except for one case where the graft was poorly positioned and converted to open surgery. The average surgical time reported in the literature is (210 ± 37) minutes, vascular anastomosis time is (41 ± 8) minutes, and warm ischemia time is (50 ± 10) minutes. There were no surgical complications.Conclusion:Transvaginal insertion of RAKT into the kidney is safe and feasible, but special types of recipients should be selected for this surgical method and evaluated before surgery.
