Less is More: Robotic Kidney Transplantation in Polycystic Kidney Disease Without Preemptive or Simultaneous Native Nephrectomy

IF 2.4 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2026-10-12 DOI:10.1002/rcs.70244

Haaris Kadri, Ryan Dang, Rossana Maffei, Dor Yoeli, Keith Hansen, Shannon Lyons, Sixto Giusti, Terri Montague, James Cooper, Rashikh Choudhury, Megan Adams, Kendra Conzen, Thomas Bak, Kristin Mekeel, Jesse D. Schold, Trevor Nydam, Peter Kennealey, Thomas Pshak, Phillipe Abreu

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引用次数: 0

Abstract

Background

Autosomal dominant polycystic kidney disease (ADPKD) often prompts pre-transplantation or simultaneous native nephrectomy.

Methods

We reviewed adult patients with ADPKD who underwent RKT without native nephrectomy at one transplant centre. Native kidney volume (NKV) and estimated abdominopelvic cavity volume (EACV) were estimated using ellipsoid approximations from cross-sectional imaging, and a Spatial Occupancy Ratio (SOR = combined NKV/EACV) was derived to quantify anatomical crowding.

Results

Sixteen patients underwent RKT for ADPKD without preemptive native nephrectomy, with a median SOR of 24.7%. Median warm ischaemia and operative times were 37 and 267 minutes, respectively, with an estimated blood loss of 50 mL. Increasing SOR demonstrated a moderate but significant inverse correlation with graft volume (r = −0.52, p = 0.038) and a weak positive correlation with operative time (r = 0.07, p = 0.80).

Conclusions

RKT without native nephrectomy appears feasible across a broad spectrum of anatomical abdominopelvic occupancy, supporting a selective rather than routine approach to nephrectomy.

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少即是多：机器人肾移植治疗多囊肾病，无需预先或同时进行原生肾切除术。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.