Transplant Team Explores Robotics as Next Horizon for Living Donation Surgery

This article is a part of University of Maryland Rounds, which features clinical and research updates from the University of Maryland School of Medicine and University of Maryland Medical Center. See more Rounds articles.

A team of transplant surgeons from the University of Maryland School of Medicine just became the first in the country to remove a living donor’s kidney through a single incision in the belly button using a surgical robot. This use of robotics was approved by the University of Maryland Institutional Review Board as a feasibility study and marks another milestone for the Division of Transplantation in its mission to improve the living donation experience.

The feasibility study will examine whether the robot demonstrates an improved operative experience for the surgeons and an improved donation experience for the patient as opposed to the standard single incision laparoscopic kidney removal through the navel. 

“We are hoping this feasibility study shows us that the robot has several advantages,” says Rolf Barth, MD, associate professor of surgery, University of Maryland School of Medicine and director, liver transplantation at the University of Maryland Medical Center. “Using the robot may decrease the length of the operation and give surgeons more precision with fine movements using the 3D video and robotic instruments.”

The transplant program at the University of Maryland is an early adopter of innovative surgical techniques. It was the first program in Maryland, and the third in the U.S., to perform single incision laparoscopic donor nephrectomies through the donor’s belly button in 2009. Since then, the team of surgeons has removed nearly 250 kidneys from living donors by making one incision in the donor’s navel, sending them out of the operating room with only a small Band-Aid and a barely visible scar.

Single-incision donor nephrectomy is a challenging operation performed at only a handful of transplant centers. “We hope to continue to identify best practices for living donation and educate other programs so that as a specialty, we can collectively attract more living donors and shorten the wait times for patients in need of transplantation,” added Barth.

The Division of Transplantation is a high volume center for kidney transplantation, performing more than 250 kidney transplants each year and investing heavily in medical and surgical research for patients with kidney disease. In 2012, the University of Maryland team published five-year outcomes data in the Annals of Surgery, demonstrating increased patient satisfaction with the cosmetic outcome and overall donation process from the single-incision laparoscopic donor nephrectomy. 

Surgeons involved in the robotics study include kidney transplant surgeons and a urologist who specializes in robotic surgery.

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