Chicago 2009 Video – Robotic transabdominal kidney transplantation in a morbidly obese patient
November 28, 2009
E. Benedetti
Background
Kidney transplantation in morbidly obese patients can be technically demanding. Morbidly obese patients present with a high rate of wound infections and related complications, with the extent and location of the incision being major contributing factors. Minimally invasive surgery could potentially avoid these complications, but conventional laparoscopic instruments are unsuitable to safely perform a kidney transplant. Herein, we report the first minimal invasive, total robotic kidney transplant in a morbidly obese patient.
Material and Methods
A left, deceased donor kidney was transplanted into a 29 year old woman with a BMI of 41 kg/m2, who had been on hemodialysis for 5 years. The operation was performed intraabdominally using the DaVinci Robotic Surgical System through a 7 cm midline incision and using 4 trocars.
Results
The operative time was 223 minutes and the blood loss less than 50 cc. The kidney presented with immediate graft function. No perioperative complications occurred. The patient was discharged home on postoperative day five with normal kidney function.
Conclusions
Minimal invasive access and robotic technology allowed to reduce the trauma due to the size and location of the incision and to safely perform a successful kidney transplant in a morbidly obese patient.