Effect of robotic assistance on the "learning curve" for laparoscopic hand-assisted donor nephrectomy

S. Horgan, Carlos A Galvani, M. V. Gorodner, G. R. Jacobsen, F. Moser, A. Manzelli, J. Oberholzer, M. P. Fisichella, D. Bogetti, G. Testa, H. N. Sankary, E. Benedetti

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: The number of living-related donor kidney transplantations have increased since the advent of minimally invasive surgery. Robotic technology has emerged as a promising alternative to laparoscopic techniques. The authors reviewed their institution experience with robotic hand-assisted donor nephrectomies (RHADNs). Methods: Between August 2000 and April 2006, 273 robotically assisted left donor nephrectomies were performed using a hand-assisted technique. Prospectively collected information for 214 patients regarding complications, hospital stay, blood loss, warm ischemia time, operative time, and outcomes is presented. Results: The cohort of donors included 110 men and 104 women with a mean age of 36 years (range, 18-61 years). These donors included 86 African Americans, 46 Caucasians, 74 Hispanics, and 8 of other races. Left renal artery anomalies were found in 61 patients (29%). Four patients underwent conversion to open surgery. The hospital stay was 2.3 days (range, 1-8 days), the blood loss 82 ml (range, 10-1,500 ml), and the mean warm ischemia time 98 s (range, 50-200 s). The operative time was 201 min (range, 100-320 min) for the first 74 cases, 129 min (range, 65-240 min) for the second 70 cases, and 103 min for the last 70 cases (p < 0.001), for an overall average of 150 min. Complications decreased significantly after the first 74 cases. The 1-year patient survival rate was 100%, and the 1-year graft survival rate was 98%. The average recipient creatinine at 6 months was 1.4 mg/dl. Conclusions: Specific changes in operative technique over time have improved patient safety and diminished complications with RHADN. Currently, RHADN can be performed expeditiously with a minimal rate of complications and conversion to open procedure by a surgical team with appropriate training and experience.

Original languageEnglish (US)
Pages (from-to)1512-1517
Number of pages6
JournalSurgical Endoscopy
Volume21
Issue number9
DOIs
StatePublished - Sep 2007
Externally publishedYes

Fingerprint

Learning Curve
Robotics
Nephrectomy
Hand
Tissue Donors
Conversion to Open Surgery
Warm Ischemia
Operative Time
Length of Stay
Survival Rate
Minimally Invasive Surgical Procedures
Living Donors
Graft Survival
Renal Artery
Patient Safety
Hispanic Americans
African Americans
Kidney Transplantation
Creatinine
Technology

Keywords

  • Donor nephrectomy
  • Kidney transplantation
  • Learning curve
  • Robotic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Horgan, S., Galvani, C. A., Gorodner, M. V., Jacobsen, G. R., Moser, F., Manzelli, A., ... Benedetti, E. (2007). Effect of robotic assistance on the "learning curve" for laparoscopic hand-assisted donor nephrectomy. Surgical Endoscopy, 21(9), 1512-1517. https://doi.org/10.1007/s00464-006-9140-5

Effect of robotic assistance on the "learning curve" for laparoscopic hand-assisted donor nephrectomy. / Horgan, S.; Galvani, Carlos A; Gorodner, M. V.; Jacobsen, G. R.; Moser, F.; Manzelli, A.; Oberholzer, J.; Fisichella, M. P.; Bogetti, D.; Testa, G.; Sankary, H. N.; Benedetti, E.

In: Surgical Endoscopy, Vol. 21, No. 9, 09.2007, p. 1512-1517.

Research output: Contribution to journalArticle

Horgan, S, Galvani, CA, Gorodner, MV, Jacobsen, GR, Moser, F, Manzelli, A, Oberholzer, J, Fisichella, MP, Bogetti, D, Testa, G, Sankary, HN & Benedetti, E 2007, 'Effect of robotic assistance on the "learning curve" for laparoscopic hand-assisted donor nephrectomy', Surgical Endoscopy, vol. 21, no. 9, pp. 1512-1517. https://doi.org/10.1007/s00464-006-9140-5
Horgan, S. ; Galvani, Carlos A ; Gorodner, M. V. ; Jacobsen, G. R. ; Moser, F. ; Manzelli, A. ; Oberholzer, J. ; Fisichella, M. P. ; Bogetti, D. ; Testa, G. ; Sankary, H. N. ; Benedetti, E. / Effect of robotic assistance on the "learning curve" for laparoscopic hand-assisted donor nephrectomy. In: Surgical Endoscopy. 2007 ; Vol. 21, No. 9. pp. 1512-1517.
@article{0eb66cae3e6f47e3840ccfedda240ecd,
title = "Effect of robotic assistance on the {"}learning curve{"} for laparoscopic hand-assisted donor nephrectomy",
abstract = "Background: The number of living-related donor kidney transplantations have increased since the advent of minimally invasive surgery. Robotic technology has emerged as a promising alternative to laparoscopic techniques. The authors reviewed their institution experience with robotic hand-assisted donor nephrectomies (RHADNs). Methods: Between August 2000 and April 2006, 273 robotically assisted left donor nephrectomies were performed using a hand-assisted technique. Prospectively collected information for 214 patients regarding complications, hospital stay, blood loss, warm ischemia time, operative time, and outcomes is presented. Results: The cohort of donors included 110 men and 104 women with a mean age of 36 years (range, 18-61 years). These donors included 86 African Americans, 46 Caucasians, 74 Hispanics, and 8 of other races. Left renal artery anomalies were found in 61 patients (29{\%}). Four patients underwent conversion to open surgery. The hospital stay was 2.3 days (range, 1-8 days), the blood loss 82 ml (range, 10-1,500 ml), and the mean warm ischemia time 98 s (range, 50-200 s). The operative time was 201 min (range, 100-320 min) for the first 74 cases, 129 min (range, 65-240 min) for the second 70 cases, and 103 min for the last 70 cases (p < 0.001), for an overall average of 150 min. Complications decreased significantly after the first 74 cases. The 1-year patient survival rate was 100{\%}, and the 1-year graft survival rate was 98{\%}. The average recipient creatinine at 6 months was 1.4 mg/dl. Conclusions: Specific changes in operative technique over time have improved patient safety and diminished complications with RHADN. Currently, RHADN can be performed expeditiously with a minimal rate of complications and conversion to open procedure by a surgical team with appropriate training and experience.",
keywords = "Donor nephrectomy, Kidney transplantation, Learning curve, Robotic surgery",
author = "S. Horgan and Galvani, {Carlos A} and Gorodner, {M. V.} and Jacobsen, {G. R.} and F. Moser and A. Manzelli and J. Oberholzer and Fisichella, {M. P.} and D. Bogetti and G. Testa and Sankary, {H. N.} and E. Benedetti",
year = "2007",
month = "9",
doi = "10.1007/s00464-006-9140-5",
language = "English (US)",
volume = "21",
pages = "1512--1517",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - Effect of robotic assistance on the "learning curve" for laparoscopic hand-assisted donor nephrectomy

AU - Horgan, S.

AU - Galvani, Carlos A

AU - Gorodner, M. V.

AU - Jacobsen, G. R.

AU - Moser, F.

AU - Manzelli, A.

AU - Oberholzer, J.

AU - Fisichella, M. P.

AU - Bogetti, D.

AU - Testa, G.

AU - Sankary, H. N.

AU - Benedetti, E.

PY - 2007/9

Y1 - 2007/9

N2 - Background: The number of living-related donor kidney transplantations have increased since the advent of minimally invasive surgery. Robotic technology has emerged as a promising alternative to laparoscopic techniques. The authors reviewed their institution experience with robotic hand-assisted donor nephrectomies (RHADNs). Methods: Between August 2000 and April 2006, 273 robotically assisted left donor nephrectomies were performed using a hand-assisted technique. Prospectively collected information for 214 patients regarding complications, hospital stay, blood loss, warm ischemia time, operative time, and outcomes is presented. Results: The cohort of donors included 110 men and 104 women with a mean age of 36 years (range, 18-61 years). These donors included 86 African Americans, 46 Caucasians, 74 Hispanics, and 8 of other races. Left renal artery anomalies were found in 61 patients (29%). Four patients underwent conversion to open surgery. The hospital stay was 2.3 days (range, 1-8 days), the blood loss 82 ml (range, 10-1,500 ml), and the mean warm ischemia time 98 s (range, 50-200 s). The operative time was 201 min (range, 100-320 min) for the first 74 cases, 129 min (range, 65-240 min) for the second 70 cases, and 103 min for the last 70 cases (p < 0.001), for an overall average of 150 min. Complications decreased significantly after the first 74 cases. The 1-year patient survival rate was 100%, and the 1-year graft survival rate was 98%. The average recipient creatinine at 6 months was 1.4 mg/dl. Conclusions: Specific changes in operative technique over time have improved patient safety and diminished complications with RHADN. Currently, RHADN can be performed expeditiously with a minimal rate of complications and conversion to open procedure by a surgical team with appropriate training and experience.

AB - Background: The number of living-related donor kidney transplantations have increased since the advent of minimally invasive surgery. Robotic technology has emerged as a promising alternative to laparoscopic techniques. The authors reviewed their institution experience with robotic hand-assisted donor nephrectomies (RHADNs). Methods: Between August 2000 and April 2006, 273 robotically assisted left donor nephrectomies were performed using a hand-assisted technique. Prospectively collected information for 214 patients regarding complications, hospital stay, blood loss, warm ischemia time, operative time, and outcomes is presented. Results: The cohort of donors included 110 men and 104 women with a mean age of 36 years (range, 18-61 years). These donors included 86 African Americans, 46 Caucasians, 74 Hispanics, and 8 of other races. Left renal artery anomalies were found in 61 patients (29%). Four patients underwent conversion to open surgery. The hospital stay was 2.3 days (range, 1-8 days), the blood loss 82 ml (range, 10-1,500 ml), and the mean warm ischemia time 98 s (range, 50-200 s). The operative time was 201 min (range, 100-320 min) for the first 74 cases, 129 min (range, 65-240 min) for the second 70 cases, and 103 min for the last 70 cases (p < 0.001), for an overall average of 150 min. Complications decreased significantly after the first 74 cases. The 1-year patient survival rate was 100%, and the 1-year graft survival rate was 98%. The average recipient creatinine at 6 months was 1.4 mg/dl. Conclusions: Specific changes in operative technique over time have improved patient safety and diminished complications with RHADN. Currently, RHADN can be performed expeditiously with a minimal rate of complications and conversion to open procedure by a surgical team with appropriate training and experience.

KW - Donor nephrectomy

KW - Kidney transplantation

KW - Learning curve

KW - Robotic surgery

UR - http://www.scopus.com/inward/record.url?scp=34547647390&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547647390&partnerID=8YFLogxK

U2 - 10.1007/s00464-006-9140-5

DO - 10.1007/s00464-006-9140-5

M3 - Article

C2 - 17287916

AN - SCOPUS:34547647390

VL - 21

SP - 1512

EP - 1517

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 9

ER -