Robot-Assisted Kidney Transplant

A robot-assisted kidney transplant is an advanced alternative to kidney transplant surgery. This surgery replaces a damaged or non-functioning kidney with a healthy kidney. It is usually recommended for patients with end-stage kidney failure in one or both kidneys. In a robot-assisted kidney transplant, the replacement is performed with the help of an advanced robotic system—mechanical arms—instead of an open surgery or laparoscopy. This makes the surgery minimally invasive, reducing the risk of complications and improving surgical outcomes.

Alternate Name

Robotic renal transplant

Body Location

Kidneys

Procedure Type

Surgical

Preparation

Kidney transplants need a thorough evaluation.

• Doctors will test you to ensure you qualify for a kidney transplant. They may place you on dialysis, which may extend lifelong if you are not eligible for a kidney transplant.
• Conditions, such as cancer and substance abuse, can increase the chances of kidney transplant failure, meaning you might not be eligible for one.
• If deemed fit for a transplant based on your medical history, you will be asked to undergo tests like cross-matching, blood typing, and tissue typing to check your compatibility for a kidney. You may be on the waiting list for months, during which these tests may be carried out regularly.
• Once a matching organ is available, surgery will be scheduled.
• The doctor will ask you to fast at least 8 hours before the surgery.
• On the day of the surgery, the doctor will brief you about the procedure and address your questions. They may also give you medicine to help you relax.

How is it Performed?

Kidney transplants are an option for people with end-stage kidney failure in one or both kidneys. This condition is also called end-stage renal disease (ESRD). At this stage, many patients are already on dialysis, failing which, they are asked to undergo transplant surgery.

Most patients getting a kidney transplant only get one kidney since people waiting for kidneys outnumber the kidneys available. The source of the new or healthy kidney can be someone deceased or living.

In a robot-assisted kidney transplant, mechanical arms controlled by a console are used to perform the surgery. In this surgery, the initial incisions are much smaller than those typically made in laparoscopic or open surgery. Through these tiny incisions, the surgeon uses a console to navigate the arms that hold the surgical instruments and the camera that provides 3D real-time visualization of the surgical field.

The surgeon uses the incision to remove the diseased/damaged kidney while securing the nearby blood vessels, ureters, and other organs. Once secured, the new kidney is placed, and the mechanical arms connect it to the blood vessels and ureters. The mechanical arms are designed to mimic the movement of a surgeon’s hands, which improves the precision of this surgery through such a small incision. Once done, the surgeon checks the surgical field for residual bleeding and closes the incision site if no complications are observed. The surgeons often remove only the kidney being replaced and leave the other diseased/damaged kidney in the body.

Follow-up

After the surgery, the medical team will take you to the ICU and monitor your vitals continuously for several days. You might spend a few days to a week in the hospital. The hospital stay might be shorter in the case of robot-assisted kidney transplants.

While in the hospital, the medical team will conduct regular blood tests. Your new kidneys may take time to start working properly and produce urine, so you might need temporary dialysis until they start functioning properly.

Additionally, doctors may monitor your tests to check for any signs of organ rejection. You may also be given various medicines, including immunosuppressants, to prevent organ rejection. Apart from this, you may be monitored for post-op infections. The doctor may suggest avoiding strenuous activity to prevent tearing your stitches.

Risks

Kidney transplant surgery is a serious surgery and hence carries significant risks. It is reserved only for people with end-stage renal failure and when dialysis is not viable. Some of its risks are:

• Uncontrolled bleeding
• Post-operative infections
• Blockage of blood vessels
• Leakage of urine or blockage of ureters
• Lack of urine production in the new kidney

Recovery

Complications such as bleeding or infection are usually lower with a robot-assisted kidney transplant. However, kidney transplants require a significant amount of aftercare.

In the initial stages of recovery, you may need dialysis until your new kidney begins functioning fully. You may also have to follow a strict diet to prevent overburdening your kidney. For example, grapefruits must be avoided as they interfere with immunosuppressants.

As far as diet and nutrition are concerned, there are changes, but you will be asked to make fewer changes to your diet than you might have had to do with dialysis. If you have pre-existing conditions like diabetes, high blood pressure, etc., it is recommended to manage them well to prevent burdening the new kidney. You may be asked to avoid strenuous physical activity or lift heavy objects. Surgeons recommend walking or low-impact training to improve your physical and mental health. It should be done under the guidance of your physician only. Your doctor may also ask you to join transplant rehabilitation support to help you with the emotional impact of the surgery.