A Closer Look at Single-Port Robotic Kidney Transplant: Venous and Arterial Anastomosis (Video)

The team behind the world’s first successful kidney transplant using a single-port (SP) robot published a case series on initial experiences and outcomes in European Urology. The article highlights the application of the SP robot-assisted approach for kidney allotransplantation and autotransplantation and demonstrates its safety, acceptability and promising early outcomes in indicated patients.

Alvin Wee, MD, MBA, Surgical Director of Renal Transplantation at Cleveland Clinic, collaborated on the case series with Jihad Kaouk, MD, who leads the Center for Robotic and Image-Guided Surgery and Mohamed Eltemamy, MD, who is a staff member for both sections, and others.

The paper highlights three autotransplantation cases, showing how the technique can be used to facilitate excessive stone passage, resolve ureteral injury and chronic kidney pain, respectively. In each of these cases, the authors report, the procedures were completed successfully with unremarkable postoperative serum creatinine levels and good early outcomes.

A technically challenging procedure

Dr. Eltemamy urologic surgeon and staff member within the Glickman Urological & Kidney Institute’s sections of Robotic and Image-Guided Surgery and Renal Transplantation, offers a closer look at this technically challenging procedure.

In the case captured below, he performs the venous and arterial anastomosis during an SP robotic kidney transplantation using running Gore-Tex sutures. The implantation of the allograft is done extraperitoneally, which is in contrast to other robotic transplantation where it is done intraperitoneally. To do this, the team begins with a 4 to 6 cm infraumbilical incision (this can differ based on the size of the kidney), then develops the extraperitoneal space manually before docking the robot.

On this breakthrough approach, Dr. Eltemamy says, “We are committed to delivering care to our patients with the most innovative techniques available. When indicated, this approach can lead to better postoperative outcomes than standard of care techniques.”