Robot-assisted living donor kidney transplant: Step by step procedure of the robotic implant

Abstract

Introduction: Robot-assisted kidney transplantation (RAKT) has become a promising alternative to open surgery. Despite its challenges, the technique offers significant patient benefits, such as reduced blood loss, less postoperative pain, and faster recovery.

Objectives: To describe the surgical procedure and outcomes of the first RAKT case performed in the Canary Islands.

Material and Methods: We present the case of a 52-year-old male patient with end-stage renal disease who received a living donor kidney transplant from his 47-year-old brother. The donor nephrectomy was performed laparoscopically, and the implantation was carried out using the Da Vinci Xi® robotic system through a Pfannenstiel incision. The step-by-step procedure is detailed, from recipient preparation to ureteral anastomosis.

Results: The total surgical time was 180 minutes, with 40 minutes of warm ischemia. There were no complications, and the graft function was immediate, with minimal blood loss. The patient was discharged on the seventh postoperative day with favorable progress and a serum creatinine level of 1.2 mg/dL.

Conclusions: This case demonstrates the feasibility and safety of RAKT in centers with experience in robotic surgery. Furthermore, it highlights the essential role of surgical nursing, whose technical knowledge and active participation are crucial for the success of such complex procedures. However, training in this field remains limited due to the lack of formal specialization and the scarcity of published nursing literature. Sharing experiences like this one is vital for advancing nursing practice in high-complexity surgical settings. The outcomes observed were consistent with previously reported data, supporting RAKT as a reference technique in kidney transplantation