Robot-assisted kidney transplantation: comparison of the first 40 cases of open vs robot-assisted transplantations by a single surgeon.

Objective: To compare the outcomes of the first 40 patients to undergo robot-assisted kidney transplantation (RAKT) with those of the first 40 patients who underwent open KT (OKT) by a single surgeon at the Dr Sadi Konuk Training Hospital.

Patients And Methods: We prospectively collected the data of the first 40 patients to undergo RAKT between January 2016 and February 2017 (RAKT group), and compared them with the first 40 patients to undergo OKT between November 2010 and April 2015 (OKT group). Comparisons were made using one-way analysis of variance or the Kruskal-Wallis test for continuous variables, and the chi-squared or Fisher's exact test for categorical variables.

Results: There were 40 patients in both the RAKT and OKT groups. In the RAKT group, the mean (SD) operative time was 265.375 (46.63) min, total ischaemia time was 96.7 (30.02) min, re-warming time was 54.70 (17.80) min, and estimated blood loss (EBL) was 182.25 (55.26) mL. Whilst in the OKT group the mean (SD) operative time was 250.25 (41) min (P = 0.129), total ischaemia time was 71.79 (8.55) min (P < 0.01), re-warming time was 37.30 (4.07) min (P < 0.001), and EBL was 210.75 (28.96) mL (P = 0.005). At 12-24 h postoperatively, linear visual analogue scale pain scores were significantly lower in the RAKT group (P < 0.001), and the RAKT group had a significantly shorter drain withdrawal time, at a mean (SD) of 3.45 (0.93) vs 7.67 (2.11) days in the OKT group (P < 0.001).

Conclusion: Satisfactory functional outcomes can be achieved by either OKT or RAKT. However, the latter technique seems to have some advantages over the former in that it is less invasive, results in less pain postoperatively, has a shorter drain withdrawal time, and has the potential for fewer complications.