Robotic Kidney Transplantation Offers Hope for Obese Transplant Patients

By Raquel Garcia Roca, MD, Transplant Center

For people with kidney failure, a kidney transplant offers freedom from dialysis and hope for the future.

Patients who receive a new kidney experience a transformational life change. Healthier and more energetic, they can resume the activities they love to do.

Loyola Medicine offers robotic kidney transplantation to expand access to kidney transplants for some patients.

First performed at Loyola in November 2020, this treatment uses state-of-the-art technology to transplant a kidney from a deceased or living donor to the recipient.

How is a Robotic Kidney Transplant Useful for Obese Patients?

Obesity is a condition that can disqualify someone from receiving a kidney transplant. Many transplant centers require patients who are obese to lose weight before they consider performing transplant surgery. For patients on dialysis and managing other chronic health conditions, weight loss can be out of reach.

Currently, doctors recommend robotic kidney transplantation only for patients living with obesity. Compared with open surgery, minimally invasive robotic surgery has many advantages for these patients:

• The risk of infection decreases from about 30% to 5%: infection after surgery requires additional medical care and, in some cases, hospitalization. It can also jeopardize the transplanted kidney.
  
  
  
  
• The incision is much smaller: the golf-tee-length incision reduces pain and the need for narcotic pain medication.
  
  
  
  
• The duration of the surgery is shorter: implant success is related to the time it takes the surgeon to connect the blood vessels and ureter (the tube that carries urine from the kidney).
  
  
  
  
• Patients can monitor their incisions better: not only are the incisions smaller, but they are also located higher up on the abdomen than with open surgery. This position makes them easier to see and keep clean and dry.

In patients who are not obese, studies show similar results between open surgery and robotic surgery. Therefore, doctors perform kidney transplants using open surgical procedures in nonobese patients.

Loyola's Team Approach to Kidney Transplant

The Loyola kidney transplant team includes an experienced and collaborative group of doctors, nurses and other specialists. For robotic surgeries, several team members have special training on the robotic equipment — the da Vinci robotic system.

Da Vinci training is intense and comprehensive. It includes many rounds of testing and a mentorship program to ensure mastery of the robotic system and kidney transplant procedures.

The robotic kidney transplant team includes:

• Transplant surgeon, who performs the surgery at the virtual reality console
• Assistant surgeon, who helps at the bedside with the surgery and instrument changes
• Scrub nurses, who help manage the robot

What are the Benefits of Robotic Kidney Transplantation?

New techniques and technologies, like robotic surgery, have improved safety and patient outcomes since doctors conducted the first kidney transplant in 1954.

One of the main benefits of robotic surgery is that the instruments provide a range of motion similar to the human wrist. A virtual reality platform then translates the surgeon’s movements to the robotically controlled instruments inserted through small incisions.

The robotic system also uses computer-assisted motion scaling that eliminates tremors, making the robotic arms steadier than human hands.

Robotic Kidney Transplantation at Loyola Medicine

Since 2020, Loyola surgeons have performed robotic transplants on at least 10 patients with kidney failure. Feedback from patients has been very positive.

Patients are pleased with the small incisions that the robotic system uses. Some are also grateful for the transplant opportunity that was not available to them at other centers.

The team at the Loyola Transplant Center evaluates all patients with kidney failure. If a provider has asked you to lose weight before a kidney transplant, call 708-327-3700 to speak with our transplant team.

Raquel Garcia Roca, MD, is a transplant surgeon and program director of the abdominal transplant program at Loyola Medicine. She loves watching her patients’ lives transform after a transplant as they feel healthier and more energetic. Her research interests focus on understanding and reducing disparities in living organ donation and optimizing robotic-assisted systems for transplant surgeries.

Dr. Garcia Roca earned her medical degree at the Universidad de Valencia Facultad de Medicina, Spain. She completed a residency in general surgery at Jackson Memorial Hospital and fellowships in transplant surgery at the University of Miami Hospital and University of Minnesota Medical School.

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