Zeuschner P, Siemer S, Stöckle M
Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
Urologe A. 2020 Jan;59(1):3-9. doi: 10.1007/s00120-019-01085-9.
Robot-assisted surgery has become widely adopted in urology due to advantages in comparison with laparoscopic or open approaches. Robot-assisted living kidney transplantation is one of the most challenging procedures in urology regarding technical, but also psychological and ethical aspects, and is currently routinely performed in two German departments.
The goal was to analyze and compare current evidence and experiences of robot-assisted living kidney transplantation in Europe and in Germany.
A systematic search was performed to identify relevant publications. They were compared with latest results from two German academic centers (Halle and Homburg/Saar).
In 2015, robot-assisted living kidney transplantation was performed for the first time in Europe. Since then, 8 academic centers have established this procedure. Until today, more than 180 robot-assisted kidney transplantations have been performed. Short- and mid-term results have proven to be excellent with low complication rates. Apart from 3 transplant losses because of arterial thrombosis and 5 surgical re-explorations due to hematoma, no other noteworthy complications occurred. There was only 1 lymphocele. The median blood loss was 150 ml and kidney function after 1 year was unchanged in comparison with postoperative day 30.
Robot-assisted living kidney transplantation is not inferior to the open approach. Even superiority is not unlikely because problematic situations such as obese patients or complex vascular anatomy can be handled safely. In particular, the development of lymphocele and wound healing disorders appear to be significantly decreased compared to conventional surgery.
与腹腔镜或开放手术方法相比，机器人辅助手术因其优势已在泌尿外科广泛应用。机器人辅助活体肾移植在技术、心理和伦理方面都是泌尿外科最具挑战性的手术之一，目前在德国的两个科室常规开展。
分析和比较欧洲及德国机器人辅助活体肾移植的现有证据和经验。
进行系统检索以确定相关出版物。将其与德国两个学术中心（哈雷和洪堡/萨尔）的最新结果进行比较。
2015年，欧洲首次进行了机器人辅助活体肾移植。自那时起，已有8个学术中心开展了该手术。截至目前，已进行了180多例机器人辅助肾移植手术。短期和中期结果显示极佳，并发症发生率低。除了3例因动脉血栓形成导致移植肾丢失和5例因血肿进行手术再次探查外，未发生其他值得注意的并发症。仅出现1例淋巴囊肿。中位失血量为150毫升，术后1年的肾功能与术后第30天相比无变化。
机器人辅助活体肾移植并不逊色于开放手术。甚至有可能更具优势，因为肥胖患者或复杂血管解剖等问题情况能够安全处理。特别是，与传统手术相比，淋巴囊肿的形成和伤口愈合障碍似乎明显减少。
