Smt. G. R. Doshi and Smt. K. M. Mehta Institute of Kidney Diseases and Research Centre & Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad-380016, India.
Smt. G. R. Doshi and Smt. K. M. Mehta Institute of Kidney Diseases and Research Centre & Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad-380016, India.
Urology. 2020 Oct;144:234-240. doi: 10.1016/j.urology.2020.06.030. Epub 2020 Jul 2.
To demonstrate the surgical technique of dual kidney transplantation in ipsilateral iliac fossa using da Vinci Si robotic platform METHODS: Dual kidneys from expanded criteria deceased donor were used in single recipients using robotic platform in 6 recipients. Following bench surgery, both kidneys were again placed into preservation fluid and ice-box. Robot was docked between 2 legs of the recipient. Common iliac and external iliac vessels on right side were dissected using robotic instruments. A 7 cm pfannenstiel incision was placed and one kidney was dropped into the abdomen; external aponeurosis was closed to restore the pneumoperitoneum. First kidney vascular anastomosis was done with common iliac vessels. Second kidney was introduced through the same wound and transplanted with external iliac vessels. Both ureters were implanted separately into the bladder.
Between January 2013 and December 2017, 6 patients had dual robotic-assisted laparoscopic kidney transplantation. All procedures were carried out successfully without conversion to open operation. Mean time for venous anastomosis, arterial anastomosis and total operation were 16.4 (10-19) minutes, 17.5 (13-24) minutes, and 359.1 (265-500) minutes. Mean blood loss was 188.3 (80-300) ml. Two patients had delayed graft function. One patient expired 3 months following transplant due to pneumonia.
Using 7 cm Pfannenstiel incision, dual robotic-assisted laparoscopic kidney transplantation with common iliac and external iliac vessels is technically feasible.
展示使用达芬奇 Si 机器人平台在同侧髂窝进行双肾移植的手术技术。
在 6 名受体中，使用机器人平台从扩大标准的已故供体中使用双肾。在完成 bench surgery 后，将两个肾脏再次放入保存液和冰盒中。机器人在受体的两腿之间对接。使用机器人器械解剖右侧髂总动脉和髂外动脉。放置一个 7 cm 的 Pfannenstiel 切口，将一个肾脏放入腹部；关闭外膜以恢复气腹。进行第一肾动静脉吻合术与髂总动脉吻合。第二肾通过相同的切口引入并与髂外血管移植。将两条输尿管分别植入膀胱。
2013 年 1 月至 2017 年 12 月，6 例患者接受了双机器人辅助腹腔镜肾移植。所有手术均成功完成，无需转为开放性手术。静脉吻合、动脉吻合和总手术时间的平均值分别为 16.4（10-19）分钟、17.5（13-24）分钟和 359.1（265-500）分钟。平均失血量为 188.3（80-300）ml。两名患者出现延迟移植物功能。一名患者在移植后 3 个月因肺炎死亡。
使用 7 cm Pfannenstiel 切口，使用机器人进行髂总动脉和髂外动脉的双肾移植在技术上是可行的。
