Single-setting robot-assisted kidney transplantation consecutive to single-port laparoscopic nephrectomy in a child and robot-assisted living-related donor nephrectomy: initial Ghent experience.

Kidney transplantation (KT) is the gold-standard treatment for end-stage renal disease (ESRD) in children. Robot-assisted kidney transplantation (RAKT) in adults is becoming increasingly common with potentially improved morbidity compared with open KT. The study objective was to evaluate feasibility and outcomes of RAKT in children.

An 8-years-old boy with ESRD received a kidney transplant from his mother. Simultaneously in two operation theatres, the boy underwent single-port (GelPOINT®) right laparoscopic nephro-ureterectomy (LNU), and his mother underwent robot-assisted left donor nephrectomy (RADN).Two full surgical teams were operating at the same time. Subsequently, the boy underwent RAKT, introducing the graft through the GelPOINT®.

Total operative time for LNU, RADN, and RAKT was 180, 140, and 195 min, respectively, with warm, cold, and rewarming ischemia times 1.5, 200, and 47 min, respectively. Blood loss was 300, 20, and 50 cc, respectively. No intraoperative complications were noted. Convalescence of both donor and recipient was uneventful, with good kidney function at 1-year follow-up.

RAKT in children is technically feasible and safe, resulting in excellent graft function. Concomitant nephrectomy can be done laparoscopically through the single-site GelPOINT®. An experienced RAKT team with the full support of pediatric nephrologists is mandatory.

Journal of pediatric urology. 2019 Aug 16 [Epub ahead of print]

Anne-Françoise Spinoit, Nathalie Moreels, Ann Raes, Agnieszka Prytula, Ruben De Groote, Achilles Ploumidis, Elise De Bleser, Caren Randon, Caroline Vanpeteghem, Johan Vande Walle, Erik Van Laecke, Frank Vermassen, Karel Decaestecker

Department of Urology, Ghent University Hospital, Ghent, Belgium. Electronic address: ., Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium., Department of Pediatrics, Ghent University Hospital, Ghent, Belgium., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Anesthesiology, Ghent University Hospital, Ghent, Belgium.