Surgeons at Henry Ford Hospital in Detroit and Medanta Hospital in Gurgaon, India announced they successfully transplanted kidneys into 50 recipients last year using an innovative robot-assisted procedure in which the organ is cooled with sterile ice during the operation.
“Minimally invasive surgery reduces post-operative pain and minimizes complications in comparison to conventional surgery,” says Dr. Mani Menon, chair of Henry Ford’s Vattikuti Urology Institute, and co-author of a study about the research, published in European Urology. “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.”
Henry Ford researchers and their counterparts in India reasoned that since minimally invasive robotic surgery has proven to be a great benefit to healthy kidney donors, it might also be a benefit to ill and weakened transplant recipients who are at greater risk of complications.
Noting research that shows kidney function is partially impaired in recipients if blood flow is interrupted for longer than 30 minutes during a transplant, the researchers decided to chill both the donor kidney and the transplant site with sterile ice slush.
“To our knowledge, ours is the first study to use renal cooling during robotic kidney transplant,” Menon says. “It had already proved useful during minimally invasive prostate surgeries.”
After three years of planning and simulated surgeries at Henry Ford, 50 patients underwent robotic kidney transplant at Medanta Hospital between January and October 2013.
None of the patients developed blood or urine leaks, infections, or other complications from their surgical wounds, the partners reported, and no one required dialysis after surgery. Of the first 25 patients who underwent the procedure, only two required exploratory surgery, while one person died of acute congestive heart failure.
Menon attributes the success of the study in part to a “seamless collaboration” between surgeons experienced in conventional “open surgery” kidney transplants and surgeons skilled in using robotic techniques.
“The individual surgeons involved had built an atmosphere of trust and mutual respect over 30 years of collaborative work,” Menon says. “While this benefit can’t be precisely measured, it clearly contributed to the success of this endeavor.”
The researchers note that further studies will be needed before robotic kidney transplant is widely accepted as a “reasonable” alternative to conventional transplantation.