Introduction: Guy’s Hospital has distinguished itself as the sole institution in the UK offering robotic-assisted approaches for kidney donor surgeries. This paper presents an impartial assessment of our centre’s experiences and outcomes in this field.
Methods: Our initiative commenced in December 2018 with a pilot program focusing on the first 25 cases, predominantly involving left-side nephrectomies with a single renal artery and donors with a BMI up to 26. Fifteen cases were completed in the inaugural year.
However, in December 2019, a complication necessitated a temporary suspension of our program, leading to the conversion to an open approach. Despite this, both donor and recipient outcomes remained satisfactory. Program resumption occurred in 2021 amidst the COVID-19 pandemic, which halted transplant activities across UK centres. Since then, an additional 80 cases have been performed, allowing for a comparative analysis with the hand-assisted laparoscopic donor nephrectomy, the standard procedure at our centre since 2004.
Results: Our analysis revealed no statistically significant differences in hospital stay, perioperative complications, reoperations, hospital readmissions, or donor kidney function between the robotic and hand-assisted laparoscopic approaches. While operative time was longer for the robotic approach during the pilot phase, this discrepancy diminished with experience. There was a trend toward more wound-related complications and admissions with the hand-assisted approach, though statistical significance was not achieved.
Conclusions: Robotic-assisted donor nephrectomy demonstrates itself as a viable and safe approach. As surgeon experience with robotic procedures increases, it may offer advantages over the hand-assisted laparoscopic approach. However, further research and experience are warranted to fully elucidate the comparative benefits of each technique.