Asian Scientist (Feb. 4, 2014) – A collaborative effort between surgeons at Henry Ford Hospital in the US and Medanta Hospital in India has successfully transplanted kidneys into 50 recipients using an innovative robot-assisted procedure in which the organ is cooled with sterile ice during the operation.
The procedure, described in a paper published in European Urology, shows that minimally invasive robotic surgery is a safe alternative to traditional open surgery.
“Minimally invasive surgery reduces post-operative pain and minimizes complications in comparison to conventional surgery,” says Mani Menon, M.D., chair of Henry Ford’s Vattikuti Urology Institute and co-author of the study.
“The benefits of minimally invasive surgery in removing donor kidneys has been well established in earlier studies, but the use of robot-assisted surgery in transplanting those kidneys is comparatively a frontier,” Dr. Menon adds.
The U.S. researchers and their counterparts in Gurgaon, India, reasoned that since minimally invasive robotic surgery has proven to be a great benefit to healthy kidney donors, it might also be a boon to the ill and weakened transplant recipients who are at greater risk of complications.
However, previous research showed that kidney function was partially impaired in recipients if blood flow was interrupted for longer than 30 minutes during transplant.
So they decided to chill both the donor kidney and the transplant site with sterile ice slush in hopes of increasing the amount of time in which they could safely learn and perfect the robot-assisted surgery.
“To our knowledge, ours is the first study to use renal cooling during robotic kidney transplant,” Dr. Menon says. “It had already proved useful during minimally invasive prostate surgeries.”
After three years of planning and simulated surgeries at Henry Ford, 50 consecutive transplant patients who had volunteered for the minimally invasive procedure underwent robotic kidney transplant at Medanta Hospital between January and October 2013.
When given follow-up exams six months after surgery, nearly all of the first 25 patients who underwent the procedure developed no complications, although two required exploratory surgery and one died of acute congestive heart failure.
However, the researchers noted that further studies will be needed before robotic kidney transplant is widely accepted as a “reasonable” alternative to conventional transplantation.
The article can be found at: Menon M et al. (2014) Robotic Kidney Transplantation With Regional Hypothermia: A Step-by-step Description Of The Vattikuti Urology Institute–Medanta Technique (IDEAL Phase 2a).
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Source: Henry Ford Health System; Photo: Muffet/Flickr/CC.
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