Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, Hangzhou, Zhejiang, China.
World J Urol. 2024 Apr 19;42(1):243. doi: 10.1007/s00345-024-04939-w.
Reducing operative injuries is important in living donor nephrectomy. The robot-assisted transperitoneal approach has some advantages than traditional laparoscopic techniques. However, longer operation time and risks of abdominal complications indicate the need for improved techniques. The aim of this study is to present the robot-assisted laparoscopic retroperitoneal donor nephrectomy and evaluate its safety and feasibility.
This was a retrospective study. From June 2016 to December 2020, 218 living donors underwent robot-assisted laparoscopic retroperitoneal donor nephrectomy. Perioperative data such as operation time, warm ischemia time, length of stay and complications were collected and analyzed. To evaluate the feasibility of this surgical technique, the cumulative summation method was used to construct a learning curve.
There were 60 male and 158 female donors aged 36-72 years, with an average age of 53.1 ± 6.8 years. Three patients (1.4%) were converted to open surgery. The mean operation time was 115.4 ± 41.9 min, the warm ischemia time was 206.6 ± 146.7 s, and the length of stay was 4.1 ± 1.4 days. Complications were reported in 22 patients (10.1%), three of whom (1.4%) had Clavien‒Dindo IIIa complications. No ileus occurred. No donors were readmitted. Four patients had delayed graft function. The cumulative summation curve showed that the number needed to reach proficiency was 33. The operation time and warm ischemia time after technical proficiency were 100.4 ± 21.6 min and 142.5 ± 50.7 s, respectively.
Robot-assisted laparoscopic retroperitoneal donor nephrectomy is a safe and efficient technique that offers advantages of shorter operation time and no abdominal organ interference.
减少手术损伤对于活体供肾切除术非常重要。机器人辅助经腹腔途径比传统腹腔镜技术具有一些优势。然而，较长的手术时间和腹部并发症的风险表明需要改进技术。本研究旨在介绍机器人辅助腹腔镜后腹腔供肾切除术，并评估其安全性和可行性。
这是一项回顾性研究。自 2016 年 6 月至 2020 年 12 月，218 名活体供者接受了机器人辅助腹腔镜后腹腔供肾切除术。收集并分析了手术时间、热缺血时间、住院时间和并发症等围手术期数据。为了评估该手术技术的可行性，使用累积和方法构建了学习曲线。
60 名男性和 158 名女性供者年龄 36-72 岁，平均年龄 53.1±6.8 岁。3 例（1.4%）患者转为开放手术。平均手术时间为 115.4±41.9 分钟，热缺血时间为 206.6±146.7 秒，住院时间为 4.1±1.4 天。22 例（10.1%）患者报告有并发症，其中 3 例（1.4%）有 Clavien-Dindo IIIa 级并发症。无肠麻痹发生。无供者再入院。4 例发生延迟移植物功能。累积和曲线显示达到熟练程度所需的数量为 33 例。技术熟练后的手术时间和热缺血时间分别为 100.4±21.6 分钟和 142.5±50.7 秒。
机器人辅助腹腔镜后腹腔供肾切除术是一种安全有效的技术，具有手术时间短、无腹部器官干扰的优点。
