SNUH succeeds in a single-port robotic kidney transplant

Seoul National University Hospital (SNUH) has successfully performed a single-port robotic living donor kidney transplantation, offering a minimally invasive alternative to traditional surgery.

A team led by Professor Ha Jong-won of the Department of Transplantation and Vascular Surgery at SNUH announced on Thursday that they had carried out a living donor kidney transplantation using a single-port robot, demonstrating its safety and therapeutic efficacy.

Following the successful removal of a donor kidney using a single-port robot in February, the team also applied the single-port robot to a recipient in March. SUNH has performed 10 single-port robotic kidney transplants (five donors and five recipients).

So far, kidney transplants have been performed using open, laparoscopic, and multi-port robotic techniques. Open surgery requires an incision longer than 20 centimeters, resulting in prolonged recovery and large scars. Laparoscopic and multi-port robotic surgeries reduce the incision size but necessitate multiple cuts.

However, in single-port robotic surgeries, a single, small incision is made, a 3-4cm incision around the navel for the donor and a 6cm incision in the lower abdomen for the recipient. This minimally invasive method significantly reduces pain and shortens recovery time.

Kidney transplantation requires precise anastomosis of the renal artery, vein, and ureter within a limited time and space. It is also crucial to prevent microbleeding immediately after blood flow is restored. To achieve this through a single port, a high level of surgical expertise and a standardized protocol are essential.

In one case, a 52-year-old female patient with end-stage renal failure due to “vesicoureteral reflux” received a kidney from her 24-year-old son. The donor left only a small scar of 3-4cm around the navel and was discharged three days after surgery, while the recipient left only a small scar of 6cm in the lower abdomen and was discharged seven days after surgery. The recipient’s blood creatinine level, a key indicator of kidney function, normalized from 10.7 mg/dL before surgery to 0.76 mg/dL after surgery and has remained stable to date.

Other patients, including those with polycystic kidney disease and IgA nephropathy, have also shown rapid recovery after undergoing the procedure. The surgery is expanding its applicability to high-risk and elderly patients who previously faced significant challenges with open surgery.

“Single-port robotic living donor kidney transplantation maintains the same safety as conventional open surgery, while minimizing incisions to reduce pain, accelerate recovery, and enhance cosmetic satisfaction,” Professor Ha said. “However, it is not suitable for all, so thorough evaluation and consultation with the medical team are essential to determine the best surgical method.”