Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):177-180 | DOI: 10.5507/bp.2023.034

Robotic assisted living donor nephrectomy - the first in the Czech Republic

Pavel Zemla1, Igor Hartmann1, Frantisek Hruska1, Milan Kral1 Sarka Kudlackova1, Jana Janeckova2, Petr Utikal2, Ales Vidlar1, Karel Krejcí3, Petr Bachleda2
1 Department of Urology, University Hospital Olomouc, Olomouc, Czech Republic
2 Department of Surgery II - Vascular and Transplantation Surgery, University Hospital Olomouc, Olomouc, Czech Republic
3 Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic

Introduction: A kidney transplant is the best method for treating terminal kidney failure. Long-term results of kidney transplants from living donors are significantly better than transplants from dead donors. Living kidney donors are healthy people who undergo a major operation in order to improve the health of another person. Therefore, major emphasis is on safety, low level of invasiveness and a desirable cosmetic effect of the donor nephrectomy. Since 2012, the Department of Urology at the University Hospital in Olomouc has performed 12 kidney harvestings from living donors. The kidney harvesting was conducted using various techniques.

Case Report: The first robotic assisted kidney harvesting in the Czech Republic was performed in June 2022. The donor was a 57-year-old man who donated his kidney to his 32-year-old daughter. The left kidney was evaluated as suitable for kidney harvesting. The operation took 174 min. The kidney's warm ischemia was 145 s. Based on the Clavien Dindo classification, no 2nd degree or high post-operative complications were recorded. The donor's pre-operative glomerular filtration was 1.63 mL/s. Six months post-operation, it went down to 1.19 mL/s. This represents a 27% decrease. The kidney recipient did not require early dialysis. Six months post-operation, the recipient's glomerular filtration was 2.03 mL/s.

Conclusion: In the hands of experienced professionals and transplantation centres, robotic assisted donor nephrectomy is a feasible and safe option for this operation. It not only provides all the advantages of a laparoscopic operation but it also adds other technical improvements and minimizes intraoperative stress on the surgeon. Currently, the global trend is moving towards increasing the ratio of robotic assisted donor nephrectomies.

Keywords: living donor nephrectomy, robotic operation, transplantation

Received: April 24, 2023; Revised: July 17, 2023; Accepted: July 19, 2023; Prepublished online: August 23, 2023; Published: June 10, 2024  Show citation

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Zemla, P., Hartmann, I., Hruska, F., Kral, M., Janeckova, J., Utikal, P., ... Bachleda, P. (2024). Robotic assisted living donor nephrectomy - the first in the Czech Republic. Biomedical papers, 168(2), 177-180. doi: 10.5507/bp.2023.034
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