Service of Surgery, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Am J Transplant. 2010 Dec;10(12):2708-11. doi: 10.1111/j.1600-6143.2010.03305.x.
Transvaginal recovery of the kidney has recently been reported, in a donor who had previously undergone a hysterectomy, as a less-invasive approach to perform laparoscopic live-donor nephrectomy. Also, robotic-assisted laparoscopic kidney donation was suggested to enhance the surgeon's skills during renal dissection and to facilitate, in a different setting, the closure of the vaginal wall after a colpotomy. We report here the technique used for the first case of robotic-assisted laparoscopic live-donor nephrectomy with transvaginal extraction of the graft in a patient with the uterus in place. The procedure was carried out by a multidisciplinary team, including a gynecologist. Total operative time was 215 min with a robotic time of 95 min. Warm ischemia time was 3 min and 15 s. The kidney was pre-entrapped in a bag and extracted transvaginally. There was no intra- or postoperative complication. No infection was seen in the donor or in the recipient. The donor did not require postoperative analgesia and was discharged from the hospital 24 h after surgery. Our initial experience with the combination of robotic surgery and transvaginal extraction of the donated kidney appears to open a new opportunity to further minimize the trauma to selected donors.
经阴道恢复肾脏功能最近有报道，在一位先前接受过子宫切除术的供体中，作为一种侵入性较小的方法来进行腹腔镜活体供肾切除术。此外，机器人辅助腹腔镜肾切除术被建议可以提高外科医生在肾脏解剖过程中的技能，并在不同的情况下有助于阴道壁在阴道切开术后的闭合。我们在这里报告首例机器人辅助腹腔镜活体供肾切除术的技术，该手术在子宫在位的情况下经阴道提取移植物。该手术由多学科团队进行，包括妇科医生。总手术时间为 215 分钟，机器人时间为 95 分钟。热缺血时间为 3 分 15 秒。肾脏预先被包裹在袋子中并经阴道提取。无术中或术后并发症。供体或受体均无感染。供体术后无需镇痛，并在手术后 24 小时出院。我们在机器人手术与经阴道提取捐赠肾脏相结合方面的初步经验似乎为进一步减少选定供体的创伤提供了新的机会。
