Robot-Assisted Kidney Transplantation

Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). Robot-assisted surgery has been able to overcome many of the limitations of classical laparoscopy, certainly in complex and technically demanding procedures, such as vascular and ureteral anastomosis. Since the first RAKT in 2010, this technique has been standardized and evaluated in highly experienced robot and KT centers around the world. In Europe, the European Association of Urology Robotic Urology Section (ERUS) created an RAKT working group in 2016 in order to prospectively follow the outcomes of RAKT. When performed by surgeons with both robotic and KT experience, RAKT has been proven to be safe and reproducible in selected cases and yield excellent graft function with a low complication rate. Multiple institutions have now adopted RAKT, and its use will likely increase in the near future. However, structured training and proctoring will be mandatory for those embarking on RAKT in order to help them negotiate the learning curve and avoid technical mistakes. This chapter will describe RAKT from living and deceased donors and its application in kidney autotransplantation (KAT).

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