494 Robot Assisted Kidney Transplantation in children- Dr Gauthier Gernay

This video is being presented at the Humans at the Cutting Edge of Robotic Surgery Symposium 2024, Jaipur, India. It was produced by Dr Gauthier Gernay, Ghent University hospital, Belgium.
Abstract:
Robot-Assisted Kidney Transplantation in children
Case presentation, including troubleshooting
Abstract
Author list: Gauthier Gernay1,2,3, Joris Vangeneugden1,2, Liesbeth Desender2,4, Anne-Françoise
Spinoit1,2, Charles Van Praet1,2
, Karel Decaestecker1,2,5
1 Department of Urology, Ghent University Hospital, Ghent, Belgium
2 Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
3 Junior Orsi Academy, Melle, Belgium
4 Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
5 Department of Urology, Maria Middelares Hospital, Ghent, Belgium
Introduction and objectives
The gold standard treatment for end-stage renal disease in adults is kidney transplantation, with the
robotic approach becoming the preferred technique in living donor transplantation. Little literature
exists on pediatric robot-assisted kidney transplantation (RAKT), which presents multiple challenges
compared to adult RAKT1. The aim of this video is to illustrate our RAKT technique in the pediatric
population, including troubleshooting in case of arterial embolism.
1 Grammens J, Schechter MY, Desender L, Claeys T, Sinatti C, VandeWalle J, Vermassen F, Raes A, Vanpeteghem C, Prytula A, Silay MS,
Breda A, Decaestecker K and Spinoit A-F (2021) Pediatric Challenges in Robot-Assisted Kidney Transplantation. Front. Surg. 8:649418.
Methods
RAKT is demonstrated in a 13-year-old boy with Joubert syndrome, which caused end-stage renal
disease. He received a kidney from his 48-year-old father as a living donor. The case was performed
in April 2023 in a referral center using the Da Vinci Xi® robotic system.
Results
The surgery was completed successfully, however complicated intraoperatively by an arterial
embolism of the graft, which required an embolectomy. The total surgical time was 280 minutes.
Warm ischemia time was 3 minutes, cold ischemia time 95 minutes and rewarming ischemia time 41
minutes. The patient was discharged from the hospital in good condition 17 days after the
procedure. The patient's creatinine levels dropped significantly from 5,31 mg/dL pre-transplantation
to 0,67 mg/dL one-year post-transplantation. No postoperative complications occurred during one
year of follow-up. Additionally, in the video, we report the preliminary results of our first 10 RAKT
cases.
Conclusions
RAKT is safe and feasible in children, with good clinical and esthetic outcomes, resulting in excellent
graft function. Further comparative research is needed to assess the potential benefits of the robotic
approach over the laparoscopic and open techniques.

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