First-of-its-kind robotic single-port kidney transplant surgery performed at Cleveland Clinic

Cleveland Clinic is the first hospital in the world to successfully perform a robotic single-port kidney transplant, which enables all surgical instruments and the donor's kidney to be placed through one small abdominal incision

Image courtesy: Cleveland Clinic
Image courtesy: Cleveland Clinic

Single-incision robotic surgery may decrease morbidity and recovery time for patients

The Glickman Urological & Kidney Institute surgical team included Jihad Kaouk, M.D., director of the Center for Robotic and Image-Guided Surgery; Alvin Wee, M.D., surgical director of Renal Transplantation; Mohamed Eltemamy, M.D.; David Goldfarb, M.D.; and Eric Miller, M.D.

These surgeons combined their collective expertise in minimally invasive, robotic, and kidney transplant surgery to successfully complete the operation in October.

Dr Kaouk and his team were the first in the country to successfully perform robotic single-port prostatectomy and kidney cancer surgery in September 2018. This latest surgical technique provides evidence that the single-port approach is feasible not only for patients with cancer but also for patients who are in need of a kidney transplant.

“The aim was not only to make a smaller incision but also to minimize the area in which the operation was performed by limiting the number of cuts inside the patient,” said Dr Kaouk. “This resulted in minimal post-operative pain and no opioids needed after surgery.”

The robotic single-port platform may provide an alternative option for the appropriate patient, including patients with obesity or challenging anatomy. During the operation, the surgical team created a small four-centimetre incision on the patient’s abdomen. The surgeon then used the single-port robot to prepare the site for the donor kidney, connect the blood vessels, and lastly reconstruct the urinary drainage, before suturing the incision.

“The robotic single-port approach is very promising,” said Dr Wee. “We are looking forward to continuing to refine this technique and our team is optimistic that this minimally invasive surgery can add to our range of options for kidney transplantation.”

Emilio Poggio, M.D., medical director of the Kidney Transplant Program, said, “Kidney transplantation continues to be the best treatment option for patients with end-stage kidney disease and it is a very dynamic field where innovation brings new opportunities for personalised care. As such, this first robotic single-port kidney transplant adds cutting edge practice to the care of these patients.”

Georges Haber, M.D., chair of urology in the Glickman Urological and Kidney Institute, said,  “Kidney transplantation is a life-changing event for patients, many of whose quality of life has been negatively impacted by having to receive dialysis three times a week while waiting for a donor. This technique allows patients to regain their quality of life more rapidly. Using the latest technology to help our patients live a full life is the true spirit of innovation which we foster within the department of urology here at Cleveland Clinic.”

While speaking about the impact that this new surgical tool cold have Dr Shrirang Bichu, a consultant nephrologist at Bombay Hospital, informed, “It is good that advances are being made in kidney transplant surgery. This technology will soon be available in India. But we can’t say how beneficial it would be. Not everyone would be able to afford this.”

He added, “Patients who have undergone a robotic surgery will recover sooner and be discharged. But what is more important is that one should know for how long will the donor kidney be sustainable in the recipients body. For now, the procedure used for kidney transplant in India is good. It does not cause too many complications. The patient might need to stay in hospital a bit longer, but it has a positive impact on their recovery.”

Source: Cleveland Clinic