Presentation Authors: Marine Lesourd*, Jean-Baptiste Beauval, Federico Sallusto, Nassim Kamar, Michel Soulié, Xavier Gamé, Pascal Rischmann, Mathieu Roumiguié, Nicolas Doumerc, Toulouse, France
Introduction: Kidney transplantation (KT) is the gold standard treatment for patients with end-stage renal disease. Robot-assisted kidney transplantation (RAKT) makes the transplant accessible to patients with a body mass index (BMI) greater than 30. Obese patients are mostly contraindicated for laparotomy. We present the results at 2 years of a prospective, monocentric study in patients with a BMI> 30.
Methods: A prospective, monocentric study started in December 2015 evaluating peri-operative and post-operative results of robot-assisted RT in obese patients.
Results: 16 patients were included, 4 women and 12 men with a mean age of 49 years (32-75), mean BMI of 31 kg/m2 (30-40), an average creatinine pre-transplantation at 535 micromol/L (269 -919), eGFR 11 ml/min/1.73m2 (4-24), an average ASA score of 2. The mean operating time was 168 min (110-300) with a mean duration for vascular anastomoses of 33 min (17-43) and average blood loss < 150 ml. The warm ischemia time was 44 min (28-55). 1 patient had 2 renal arteries. During the surgery, a doppler and an arteriography were performed due to poor graft staining. 1 patient had conversion to laparotomy for poor graft position. 7 days after the graft, the creatinemia was 264 micromol/l (105-850). The average length of stay was 6 days (4-8).
Conclusions: This is the first French series on RAKT in obese patients. This assisted robotic approach is reproductible and safe and opens up new opportunities for morbidly obese patients usually contraindicated in renal transplantation.