Robotic Donor Nephrectomy: Hand-Assisted Technique

Abstract

Renal transplantation is the best treatment for end-stage renal disease with living kidney donation currently the best approach to address the major shortage of available kidney grafts. The main drawback of living donation is that a healthy individual is subjected to surgical intervention, placing the living donor surgeon in a situation where doing the least possible harm is more important than ever. With its remarkable advantages, robotic technology has become very appealing for surgeons performing complex procedures requiring a high level of precision. After gaining robotic experience with other procedures, we performed the first transabdominal hand-assisted robotic donor nephrectomy, a procedure which rapidly became our preferred approach for kidney donor surgery. Over the last 11 years we have performed more than 700 robotic donor nephrectomies with excellent results and describe our technique in this chapter. Based on our experience, we believe that robotic donor nephrectomy is a safe procedure that is relatively easy to master and offers significant advantages, especially for donors with higher BMI and kidneys with multiple arteries.