Robotic renal transplantation: Current status

Introduction: Kidney transplantation (KT) has traditionally been performed by open renal transplantation, but recently, a few groups including our own have described a minimally invasive approach to KT. We aim to discuss the current status of robotic kidney transplantation (RKT) and describe our technique of RKT with regional hypothermia. Material and Methods: We used the search terms "minimally invasive" OR "robotic" OR "robot assisted" AND "kidney transplantation." Papers written in English and concerning technical and/or clinical outcomes following minimally invasive kidney transplantation were selected. Three hundred and eighteen unique articles were retrieved and nine were relevant. Comparative outcomes data following RKT with regional hypothermia versus open KT (OKT) from our own group were also included. Findings: Nine papers, so far, have evaluated the role of robotic approach in KT and have conclusively established the feasibility, safety, and reproducibility of RKT, although these studies have been performed by experienced robotic surgeons/teams. The contemporary published series note that rejection rates were similar in RKT and OKT patients. Mean serum creatinine at 6 months in RKT and OKT patients was equivalent, across the three series. Most of the studies also note a dramatic reduction in the wound-related complication rates. Conclusion: RKT appears to be a safe surgical alternative to the standard open approach of KT. RKT is associated with reduced postoperative pain, analgesic requirement, and better cosmesis. RKT, although in its infancy, appears to be associated with lower complication rates.