Abstract：Objective： To explore the safety and feasibility of robot-assisted laparoscopic kidney transplantation. Methods： The clinical data of 22 patients who underwent robot-assisted laparoscopic kidney transplantation in our hospital from February 2019 to August 2020 were chosen, including 13 males and 9 females, aged （39.2 ± 7.3） years old, and body mass index was （22.4 ±3.9） kg/m2. One case had a history of abdominal surgery. Preoperative creatinine was （1 045.7 ± 256.4） μmol/L, and dialysis time was （45.6 ± 10.2） months. All patients were diagnosed as chronic renal insufficiency uremic stage. For the surgical procedure, the patients were intubated under general anesthesia. The abdominal 6-trocar distribution was used. The pneumoperitoneum pressure was 1.729 kPa （13 mmHg）. The central incision of the abdomen was made and a self-made single hole platform was placed. The right peritoneum was cut to establish a kidney nest, the external iliac arteries and veins were dissociated outside of the peritoneum, the transplanted kidney was placed through a single port platform, the external iliac vein was interrupted and cut, end-to-side anastomosis with the transplanted renal vein was done, the grafted renal artery was anastomosed in the same way, the transplanted kidney was placed into the peritoneum in the outer kidney nest, the transplanted ureter and bladder were replanted, and the cut lateral peritoneum was sutured, and the transplanted kidney was fixed in the kidney nest. The transplanted kidney and ureter were completely peritoneally externalized. Results： All 22 operations were successfully completed. There was no transfer to open operation. No intraoperative blood transfusion was given. The total operation time was （225.0 ± 37.9） min, operating table time was （112.0 ± 25.8） min, blood loss was （110.9 ± 60.8） mL, and hospital stay was （22.1 ± 10.26） d. The creatinine was （225.5 ± 124.1）, （116.2 ± 49.5） and （109.2 ± 32.2） μmol/L at 7th, 30th and 90th day after operation. The postoperative follow-up was 2-19 months （mean 8.6 months）. One patient with obesity had a dehiscence of the abdominal incision, one patient had stenosis in the middle of the transplanted renal artery at 3rd month after the operation, and 2 patients developed lymphatic cysts at 1st month after the operation. Conclusion： It is safe and feasible to perform robot-assisted laparoscopic kidney transplantation by surgeons who have both urological robot operation experience and skilled experience in open kidney transplantation. The incidence of complications such as bleeding and incision infection is lower than open surgery, but it takes a long time and large sample research.
谭顺成, 崔建春, 宋永琳, 李树欣, 马寅锐, 马绍翔, 孙洵. 机器人辅助腹腔镜肾移植术初步经验（附22例报告）[J]. 微创泌尿外科杂志, 2021, 10(3): 157-162.
TAN Shuncheng, CUI Jianchun, SONG Yonglin, LI Shuxin, MA Yinrui, MA Shaoxiang, SUN Xun. Preliminary experience of robot-assisted laparoscopic kidney transplantation (report of 22 cases). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(3): 157-162.
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