Initial Experience with the Use of a Robotic Stapler for Robot-Assisted Donor Nephrectomy
| Autor: | Sara Q. Perkins, Bradley J. Buck, Puneet Sindhwani, Zane C. Giffen, Jorge Ortiz, Obi Ekwenna |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology MEDLINE Living donor Nephrectomy Renal Veins 03 medical and health sciences 0302 clinical medicine Postoperative Complications Renal Artery Robotic Surgical Procedures Surgical Stapling medicine Living Donors Humans Laparoscopy Kidney transplantation Ohio medicine.diagnostic_test business.industry Middle Aged medicine.disease Kidney Transplantation Surgery Transplantation surgical procedures operative 030220 oncology & carcinogenesis Tissue and Organ Harvesting Female business |
| Zdroj: | Journal of endourology. 32(11) |
| ISSN: | 1557-900X |
| Popis: | Since the first description of robot-assisted laparoscopic donor nephrectomy for living donor renal transplantation, additional studies have noted outcomes comparable to traditional laparoscopic surgery. Urologists have embraced the technical advantages of the robotic approach, including improved dissection and more accurate graft preservation. With the advent of robotic stapling, we aim to demonstrate the feasibility of the use of robotic stapling for living-donor nephrectomies.Ten cases of da VinciOne right and nine left nephrectomies were performed by a single surgeon. Eight living donors had a single renal artery and vein, while two had multiple renal arteries and renal veins. A single vascular stapler load (45-mm, white cartridge) was used for vessels in all cases. WIT was6 minutes in each case, and EBL ranged from 13 to 100 mL. Sufficient length on the renal artery and vein was obtained to execute anastomoses in all cases. Only one patient had postoperative complications that were related to anesthesia. Graft function of recipients and postoperative renal function has been adequate to date. The cost of using the robotic stapler was $705 (EndoWrist Stapler), and the cost of the laparoscopic stapler (Endo GIA™ Stapler; Medtronic, Dublin, Ireland) was $494.06.The use of robotic stapler is feasible in terms of patient safety, technique, postoperative outcomes, 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. |
| Databáze: | OpenAIRE |
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