NARUS 2018: Initial Experience with the Use of a Robotic Stapler for Robotic-Assisted Living Donor Nephrectomy
Methods
This is a report on two cases of the da Vinci® EndoWrist® Stapler used during robotic-assisted donor nephrectomy by a single surgeon. The authors analyzed patient anatomy, estimated blood loss, postoperative complications, and graft function at discharge.
Results
A single surgeon performed both cases with the da Vinci® EndoWrist® Stapler. Both living donors had a single renal artery and vein. A single vascular stapler load (45-mm, white cartridge) was used for each vessel. The right and left kidneys, respectively, were taken. Warm ischemia time was 5 minutes for both cases, with an estimated blood loss of 20 mL and 100 mL, respectively. The surgeon was able to obtain sufficient length on the renal artery and vein to execute anastomoses of the artery and vein in both cases. Neither patient developed any immediate postoperative complications. Both donors had unremarkable hospital courses and were discharged within 36 hours of admission.
To date, the transplant recipients have excellent graft function.
The cases reported demonstrate that the use of a robotic stapler for donor nephrectomies is technically feasible and offers reasonable postoperative outcomes in terms of complications, day of discharge, and graft function on discharge.
Conclusions
The authors concluded that use of a robotic stapler is feasible in terms of patient safety, technique, and cost in both left- and right-sided living-donor robotic nephrectomies. Further research is needed to confirm the benefit and safety of EndoWrist® stapler use in robotic donor nephrectomies compared to laparoscopic stapler use.
Presented By: Zane C. Giffen, Toledo, Ohio, USA
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV