surgery with larger incisions is the gold standard procedure for a kidney
kidney transplant surgery is associated with more
pain and increased morbidityRobotic surgery isminimally invasive surgery associated with
less pain and quicker recovery. It is more accurate,
causing less tissue damage, and especially may benefit End Stage Renal Disease
(ESRD) patients with improved outcome.
First-Ever Robotic Kidney Transplant Surgery in the UK
have been used to perform kidney transplant surgeries on two Britons in the UK. The robots
were controlled by surgeons, but computerization and precision
motors allowed a high degree of accuracy not possible with open surgery. Damage
to the tissue was also markedly less, and so was the severity of pain and
recovery time following surgery.
Britons who successfully underwent kidney transplant by a robot have left
hospital just four days after the procedure. Siobhan Morris, 42, and Andy
Brooks, 58, underwent kidney transplants within a day of each another, and
become the first patients in the UK to have the procedure performed by a robot.
‘Robotic kidney transplant could revolutionize transplant surgery.’
to sources, the procedures were so precise and accurate,
with very limited damage to that tissue that paracetamol drug was
sufficient for pain relief following surgery. On the other hand, patients who
undergo open surgery need morphine infusion for relief of pain.
Patients Share Their Joy
And Amazement At The Pain Free Recovery
who previously received a kidney from her mother in 2007 said: "I was amazed.
The pain is probably 80% less than it was first time round because they cut through all
the muscles before and they didn't do any of that this time. It is so much
Brooks was given strong painkillers at first before switching to paracetamol after a
couple of days. A city worker from Sussex, he was given a kidney donated by his wife Tracy, 48, a
dance teacher. "The post-operative recovery was much shorter than it
would have been under the conventional transplant," he told the sources.
"I was operated on Saturday (September 3rd
). I was hopping out
of bed on Sunday and walking about. It was an amazing experience."
Role of Indian Surgeon
in The Landmark Kidney Transplant
Transplant surgeons at
Guy's and St Thomas' NHS Foundation Trust, with
assistance from Professor Pranjal
Modi of the Institute of Kidney Diseases and Research Centre
the robot that performed the surgery. Dr.
incidentally a pioneer in robotic transplants hailing from the western state of
Gujarat in India.
have been incredibly impressed with the difference in recovery. Normally these
patients would be on morphine infusions for two to three days," Nizam
Mamode, a consultant transplant surgeon at the hospital said.
"We think [using the robot] they will require little or no morphine. That
means they mobilize quicker, and if they mobilize
quicker and they feel better, then we would expect their overall recovery to be
first patient didn't require any morphine at all and wanted to go home on day
three," Mamode added. "Normally, in an [open surgery] transplant, you
make a big incision and you cut muscle to go in, which is then painful.
Potentially it is going to revolutionize transplantation."
rapid advancement in robots means they are being tried out in more and more NHS
procedures. Only last week a team in Oxford announced in a first time
procedure, that they had used a robot to operate upon a human eye.
About Kidney Transplant
surgical procedure in which a person with kidney failure gets a new kidney from either a living or
is felt that a successful kidney transplant gives a better quality of life
compared to long term dialysis, as it could mean greater freedom,
increased energy and less dietary restrictions.
Evolution of Kidney
Transplant Surgery Over Time
Carrel received the Nobel Prize in 1912 for perfecting the technique of
vascular anastomosis (suturing) and doing autoplastic
and homoplastic transplantation of the kidney and thyroid gland.
The first successful renal allograft transplant in human from a living donor was done by
Joseph Murray in 1954 for which he received the Nobel Prize in 1990. This success resulted in the subsequent development of other solid organ transplantation such as heart, lung, and liver. In the following 40 years, several developments in immunotherapy and pharmacology of transplantation have occurred; nevertheless, the advancement in the technical aspects of
surgery was limited.
emergence of laparoscopic living donor nephrectomy in 1995 and subsequent introduction
of robotic assisted surgery in 1999 signaled the development and advancement in
the surgical technique in kidney transplants.
Drawbacks of Traditional
Open Transplant Surgery
open surgery for renal transplant surgery is carried out by incisions placed on
the lower abdomen. The size and length of these incisions vary depending on the
surgeon's preference and the patient's condition.
general, the larger the incision, greater the degree of tissue damage.
Post-operative pain and therefore recovery and convalescence period
increased. Also they are cosmetically disfiguring.
renal transplant patients, the presence of other
co-existing conditions such as diabetes or obesity may complicate wound healing
following surgery. Use of immunosuppressants is an additional risk factor.
These concerns call for a minimally invasive approach in such cases.
Kidney Transplant Surgery
was introduced recently and its effectiveness in reducing pain and tissue
damage with improved healing was demonstrated.
referred to as computer-assisted surgery, or robotically-assisted surgery
signals the technological advancements that use robotic systems to aid
in surgical procedures. Robotically-assisted surgery was developed to
overcome the drawbacks of previously existing minimally-invasive surgical
procedures and to improve the capabilities of surgeons performing open
first full Robot Assisted Kidney Transplant
was reported by
Giulianotti and his team from Chicago in the late 2000's.
RAKT surgeries have been reported since.
Future of RAKT
kidney transplantation is fast emerging
as a modality of minimally invasive surgery
. Despite the interest in RAKT,
the current high cost remains the most prohibitive factor limiting its more
achieving adequate kidney graft function and reducing surgical complications,
robotic-assisted kidney transplantation offers hope to patients with End Stage Renal
(ESRD) to have more a realistic expectation
regarding a more positive outcome following transplant. RAKT may even
compensate the initial cost and prove profitable from a financial standpoint
when viewed long term.
robotic surgery in organ
involves usage of an
advanced level of surgical technique. It requires a high degree of skill and
expertise in any surgeon who considers using this method.
trials and long-term follow-up of RAKT recipients will be required to determine
Robotic-Assisted Dual Kidney Transplant: Surgical Technique and Report of a
Case With 24-month Follow-up - (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946483/)
- Robotic assisted kidney transplantation -