Kidney transplantation with robots

Robot-assisted kidney transplantation is a long-term solution for patients with kidney failure. Patients with kidney failure need dialysis to continue their lives because blood needs to be filtered to eliminate foreign substances. This is mechanically possible only through dialysis. Patients must undergo dialysis once or more times a week, depending on their condition. It is a tiring treatment that takes a long time for these patients. Additionally, patients’ conditions may worsen during dialysis. Therefore, if suitable, kidney transplantation is extremely effective. This article provides essential information for those curious about kidney transplantation, what to do after transplantation, and the risks involved.

Less Pain, More Confidence

Thanks to robotic surgery, it is possible to offer a beneficial outcome for individuals donating their kidney to relatives, which will be safer, less painful, and will occur with a lower rate of hernias and infections after surgery. The Da Vinci robotic surgical system significantly enhances both the visualization and maneuverability of the instruments used in the abdomen compared to the other techniques we perform under camera guidance.

The Da Vinci robotic surgical system was developed by NASA to operate remotely on astronauts in space. It consists of a surgeon’s console where the surgeon performs the surgery while seated, a patient console with robotic arms next to the patient on the operating table, and a camera system tower that provides advanced imaging. In the Da Vinci system, the surgeon performs complex and delicate surgeries by activating the robot’s other arms that can move like their own hand, accompanied by a three-dimensional image.

The kidney to be transplanted is removed through surgery without harming the tissues. In the Da Vinci Robotic System, there is a camera on the patient console and three operational arms to perform the surgery. The camera and three robotic arms are positioned on the abdominal wall at specific points based on the surgery being performed. They are inserted into the abdomen through tunnels of a specific diameter. Using thin and delicate robotic surgical arms, it is possible to surgically remove the kidney to be transplanted without damaging the tissues.

In robotic kidney transplantation, there is no need to place our hands inside the abdomen, as we safely release the kidney with the tools in the robot’s arms. This way, the incision we make for kidney removal is smaller. Robotic surgery provides an important additional advantage for those who will donate their kidney, especially in slender and tall individuals. The small incision used to remove the kidney contributes to reducing postoperative pain.

What are the benefits of the DA Vinci robotic system?

In laparoscopic or retroperitoneal surgeries performed under a regular camera, the imaging provides a two-dimensional view, just like a television. Since the Da Vinci robotic surgical system has two high-definition cameras transmitting images to each eye separately, it provides a three-dimensional view, just as if you were looking at the abdomen with your own eyes. Additionally, since it can magnify from 10 to 20 times, it allows surgery to be performed under ideal visual conditions.

The tips of the instruments used in laparoscopic or retroperitoneal surgeries can either be fixed or can rotate. The tips of the surgical instruments at the ends of the robot’s arms can rotate 540 degrees around their axis thanks to a system called “Endowrist,” giving it the capability to perform surgery even in the deepest parts of the body, above the range of human wrist movement. The Da Vinci robotic surgical system, with the “tremor scaling” feature, prevents the potential transfer of hand tremors from the surgeon to the instruments during the procedure.

Thanks to its imitation of wrist movements, the surgeon feels as if their hand is inside, providing a significantly greater advantage over the laparoscopic system, especially regarding suturing and stitching tissues.

In robotic surgery, the surgeon directs the operation using a camera and three robotic arms. This way, the incompatibility with another surgeon who directs the camera or other tools in laparoscopic surgery is eliminated. Particularly, the use of the camera by the surgeon performing the surgery ensures that the image is always in the correct focus.

In robotic surgery, the pressure of the port, which allows the instrument to pass through the abdominal wall, is minimized due to the robot’s specific working system. Along with using small-diameter (8 mm) instruments, this also contributes to reducing postoperative pain.

Surgeons stand during the procedure, which can complicate the operation due to fatigue during lengthy surgical interventions. However, the surgeon works seated in robotic surgery.

As physical fatigue decreases, the surgeon’s focus increases.

As a result of these advantages, some literature reports that robotic surgery leads to less blood loss and a shorter hospital stay.

Easier Suturing

In open kidney transplantation surgery, which is usually performed on overweight kidney transplant patients, very large incisions may be necessary. Due to both the large incision and the thick fat layer under the skin, there is a risk of postoperative complications and hernia development in these patients. With the Da Vinci robotic system, suturing has become easier, thanks to increased instrument dexterity and the provision of hand-like movements. This way, kidney veins can be safely sutured to the recipient’s veins. In suitable cases, kidney transplantation can be performed using the Da Vinci robotic system under robotic camera guidance with small incisions.

Cost of Kidney Transplantation in Turkey

What is kidney transplantation?

It is a surgical method applied in the treatment of kidney failure. Every organ has vital importance for the human body because the organs work in cooperation to ensure the continuity of life. In this cooperation, each organ has a different task. The kidneys filter waste from the blood and excrete it in urine. They also help maintain fluid and electrolyte balance in the body. When these wastes cannot be removed, they accumulate in the body and cause various diseases. People whose kidneys have failed and are no longer functioning require a treatment called dialysis. The purpose of dialysis is to remove foreign substances that accumulate in the blood. This process mechanically filters the wastes that accumulate in the bloodstream when the kidneys stop working. However, the patient must devote a lot of time to dialysis, which is a tiring method for patients. Kidney transplantation is one of the most effective treatment methods for providing a permanent solution. To perform the transplantation, a healthy kidney is taken from a living or deceased person, matched with the patient, and transplanted. Thus, the patient is freed from dialysis and can return to their active life. However, finding a suitable kidney is not always sufficient. If the patient with kidney failure has an active infection or is overweight, they may not be considered suitable for transplantation. The goal of transplantation is to take the healthy kidney and place it in the patient’s body. After transplantation, the patient can return to a healthy life, but some immunosuppressive medications must be used to prevent the immune system from rejecting the kidney.

Who needs kidney transplantation in Turkey?

Robot-assisted kidney transplantation is a technique applied to individuals whose kidneys have completely stopped working. Most patients who have reached this stage are undergoing dialysis treatment. Every dialysis patient is asked whether they have considered kidney transplantation. Patients who wish to undergo kidney transplantation are placed on a specific waiting list, and when it is their turn and a suitable kidney is found, the transplantation is performed. After kidney transplantation, some medications are used for life. However, patients who have undergone transplantation must be very careful about their nutrition. If the doctor’s instructions are not strictly followed, the transplanted kidney is at risk. Cancer patients or those who have recovered from cancer treatment, bone infections, and liver infections may find transplantation risky and vital, especially for individuals with cardiovascular diseases and acute liver diseases. Therefore, even if the patient suffers from kidney failure, they may not be suitable for transplantation. The fact that the patient will undergo a serious procedure is evident. The individual must meet all the conditions to survive this heavy surgery and regain their health. Kidney transplantation can be performed on patients with kidney failure who meet all the conditions and are in good health.

How is kidney transplantation performed?

The answer to the question of how kidney transplantation is performed with robots varies depending on the condition of the donor. In the case of a deceased individual from whom a healthy kidney will be taken, kidney transplantation must be planned immediately. Because kidney removal from deceased patients is usually the result of a fatal accident, there is a short period to preserve the organ’s health. If the tissues are compatible, the patient to be transplanted must be prepared for surgery unexpectedly. This is the only way transportation will be possible. If the donor is a healthy individual, the procedure can be planned with both the patient and the donor. Firstly, some antibody tests are performed to ensure tissue and organ compatibility. If the results are compatible, there will be no barriers to kidney transplantation. The patient is given general anesthesia to perform the surgery. After anesthesia, a healthy kidney is placed into the recipient’s body through an abdominal incision. All arteries and veins are then connected to the body. After the successful placement of the organ in the body, blood flow from the kidneys begins. Then the ureter of the healthy kidney is connected to the bladder, and the patient can urinate healthily. The other unhealthy kidney remains in the body if it does not cause blood pressure or infection. Kidney transplantation is a very important procedure. Therefore, there are some risks associated with kidney transplantation. The patient may have an allergic reaction to general anesthesia. Bleeding during the surgery is also among the dangerous situations that can occur. Additionally, among the potential risks are the formation of blood clots in the organ connected to the body, ureter leakage, or ureter obstruction. Some infections may also occur after surgery. Among the risks is the failure of the transplantation due to the immune system rejecting the transplanted kidney. The patient must accept the transplantation considering all these risks.

What are the risks of kidney transplantation for the donor?

Since kidney transplantation is an important procedure, there are some risks for both the recipient and the donor. The individual who voluntarily becomes a kidney donor is highly valued by both the patient and the doctors. Thanks to the volunteer, the patient regains their health. Many medical tests