V02-05 INTRACORPOREAL AND EXTRACORPOREAL ROBOT-ASSISTED KIDNEY AUTO-TRANSPLANTATION: EXPERIENCE OF THE ERUS RAKT WORKING GROUP

You have accessJournal of UrologyMisc. Benign Disease & Transplant & Renovascular (V02)1 Sep 2021V02-05 INTRACORPOREAL AND EXTRACORPOREAL ROBOT-ASSISTED KIDNEY AUTO-TRANSPLANTATION: EXPERIENCE OF THE ERUS RAKT WORKING GROUP Alberto Breda, Pietro Diana, Irene Giron-Nanne, Angelo Territo, Andrea Gallioli, Alberto Piana, Josep Maria Gaya, Liesbeth Desender, Benjamin Van Parys, Charles Van Praet, Joan Palou, Nicolas Doumenec, and Karel Decaestecker Alberto BredaAlberto Breda More articles by this author , Pietro DianaPietro Diana More articles by this author , Irene Giron-NanneIrene Giron-Nanne More articles by this author , Angelo TerritoAngelo Territo More articles by this author , Andrea GallioliAndrea Gallioli More articles by this author , Alberto PianaAlberto Piana More articles by this author , Josep Maria GayaJosep Maria Gaya More articles by this author , Liesbeth DesenderLiesbeth Desender More articles by this author , Benjamin Van ParysBenjamin Van Parys More articles by this author , Charles Van PraetCharles Van Praet More articles by this author , Joan PalouJoan Palou More articles by this author , Nicolas DoumenecNicolas Doumenec More articles by this author , and Karel DecaesteckerKarel Decaestecker More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001979.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Kidney auto-transplantation is a useful technique to be reserved for cases where kidney function is compromised by a complex anatomical configuration, such as long ureteric strictures and renal vascular anomalies not suitable for in situ reconstruction. Robotic-assisted kidney auto-transplantation (RAKAT) presents a novel, minimally invasive and highly accurate approach. METHODS: We retrospectively analyzed patients undergoing standard (eRAKAT) and totally intracorporeal RAKAT (iRAKAT) in a total of 3 institutions. eRAKAT consisted in a bench surgery for graft preparation after the robotic nephrectomy and was followed by graft transplantation. iRAKAT consisted in a nephrectomy phase followed by intracorporeal reperfusion and transplantation. RESULTS: Between 01/2017 and 02/2021, 29 patients underwent RAKAT. 15 and 14 were eRAKAT and iRAKAT, respectively. Median age was 42 (39-50.5) and 37.5 (25.8-55.4) for the eRAKAT and iRAKAT, respectively. In the eRAKAT and iRAKAT groups, 10, 4 and 1 patients and 10, 4, and 0 patients presented with 1, 2 and 3 arteries, respectively and 13 and 2 patients and 14 and 0 patients presented with 1 and 2 veins, respectively. Pre-op median serum creatinine and GFR were for the eRAKAT group 0.79 mg/dL (0.71-0.86) and 90 (78.4-109.1) and for the iRAKAT group 0.83 (0.76-1.05) and 84 (67-99), respectively. None required conversion to open surgery. For the standard group, median operative time was 360 min (339-397). eRAKAT median warm ischemia, cold ischemia and rewarming ischemia times were 3 (2-4), 156 (131-194), 44 (43-49.5) min respectively. For the iRAKAT group, median operative time was 307 min (292.5-467.7). Median warm ischemia, cold ischemia and rewarming ischemia times were 3 (2.8-3), 27.5 (20-55.1), 46.5 (24.2-58.2) min respectively. 3 patients developed classified as Clavien-Dindo >2 in the eRAKAT group and 1 patient for the iRAKAT, none led to graft loss. At 90 days follow-up, serum creatinine and GFR were 0.78 (0.71-0.82) and 85.5 (81.7-109.4), and 0.91 (0.8-1.1) and 81 (69-87.5) for the eRAKAT and iRAKAT group respectively. CONCLUSIONS: eRAKAT and iRAKAT represents a promising minimally-invasive technique in selected cases with acceptable ischemia time and operative outcomes. The eRAKAT technique leads to the advantages of a better graft vascular management and reconstruction. The iRAKAT technique despite the higher technical difficulty, leads to shorter cold ischemia times. Comparative studies are needed to characterize and define the indications for the two approaches. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e134-e134 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Breda More articles by this author Pietro Diana More articles by this author Irene Giron-Nanne More articles by this author Angelo Territo More articles by this author Andrea Gallioli More articles by this author Alberto Piana More articles by this author Josep Maria Gaya More articles by this author Liesbeth Desender More articles by this author Benjamin Van Parys More articles by this author Charles Van Praet More articles by this author Joan Palou More articles by this author Nicolas Doumenec More articles by this author Karel Decaestecker More articles by this author Expand All Advertisement Loading ...