Kidney transplant is a procedure done to place a functioning kidney in a patient whose own kidneys are failing. The first successful kidney transplant was done in the year 1956 by Dr. Joseph Murray, between identical twins. The recipient or the twin that had the kidney transplant lived for another 8 years. This created a momentum that was only furthered by the advances and understanding of the immunosuppression protocols (anti-rejection medicines), making it simpler for transplants to take place between those without identical genetic material or even the same blood group. Right from the time of its inception, there have been several attempts to make kidney transplants a minimally invasive procedure. While laparoscopic renal transplant was not an astounding success due to the technical difficulties, robot-assisted kidney transplant (RAKT) was met with a greater degree of enthusiasm and acceptance.
Usually, the patient’s own kidneys (which are located in the back) are not removed. Instead, the transplanted kidney is placed in the recipient’s lower abdomen and connections are made to the blood vessels supplying the lower limbs.
Conventionally, recipient surgeries are done as an open operation, where a long incision is made via the lower abdomen and the patient takes about 5 to 7 days in the hospital post-surgery. As a routine now, living donor surgery (where a relative donates a kidney) has been done laparoscopically (keyhole) for over 2 decades, which results in faster recovery and lesser pain, and decreases the number of days the patient stays in the hospital, in comparison to open donor surgeries which was a norm of the past. Just as the donor surgery evolved, a constant enthusiasm to provide an appropriate keyhole surgery for recipients has led to the development of robotic-assisted kidney transplants. Robotic surgery is probably the most fascinating surgical innovation in the last two decades.
A common misconception is that the robot operates on the patient. The fact is that the robot is only used as an interface and the humans operate using the robot. A robot has three components – a surgeon console where the surgeon sits and operates, a patient cart where the robotic arms/instruments are inserted into the patient’s abdomen and a monitor where the videos are displayed.
Components of the Robot
In RAKT, the surgeon sits in a surgeon console and the kidney is inserted through a small 5 to 6 cm incision in the lower part of the abdomen (which will be hidden below the pant line). After the kidney’s insertion into the abdomen, the kidney is connected as in the conventional open technique.
Advantages of RAKT over Open KT
Robotic surgery has certain distinct advantages over laparoscopic one, such as increased precision and magnification, a higher degree of movement than human hands and lesser pain. Robotics provide 10 times the magnification which enables the surgeon to connect even a few millimeters of blood vessels with extreme precision.
Robotic kidney transplant is superior to open transplant, particularly in obese patients in whom we would need a large incision to place and connect the kidney in the abdomen; instead, we leave them with a cosmetically smaller and less painful incision irrespective of their body weight.
Usually, following an open operation, patients get discharged in 1 week. However, after a robotic kidney transplant, patients go home as soon as 4 days. They resume all their routine work within a few weeks.
With increasing use, the overall cost of robotic surgery has come down in the last decade. In India, most of the insurances provide cover for robotic procedures. The launch of the Kauvery Institute of Robotic Surgery propelled the initiation of the RAKT program. Its dedicated and experienced team of robotic surgeons, nephrologists, anesthetists and OT personnel, have pioneered robotic kidney transplants in the state of Tamil Nadu and have successfully done several of them with outcomes as good as open kidney transplants. In fact, the renal transplant program at Kauvery Hospital is the only program in the state to offer RAKT at an affordable cost.
Dr. Anu Ramesh
Consultant Urologist,
Kauvery Hospital, Chennai
Dr Swaminathan Sambandam
Senior Consultant & Lead, Multi-Organ Transplant (Liver, Kidney, Pancreas & Small Intestine),
Kauvery Hospital, Chennai
Images Courtesy – Robotic Kidney Transplantation with Regional Hypothermia: A Step-by-step Description of the Vattikuti Urology Institute–Medanta Technique (IDEAL Phase 2a) – europeanurology.com
With Deep Gratitude for Your Healing Touch
Our hearts are brimming with Ecstasy as we complete 1 year to my new LIFE post my ROBOTIC RENAL TRANSPLANT… 😍 All Divine Blessings n GOD’s Benevolent and Unimaginable GRACE has made this MIRACLE happen that I was lucky that my Husband could be my Donor ❤️.
No combination of alphabets suffice to express our humble Gratitude to the medical team of Kauvery Hospital under the Compassionate , Holistic and expert guidance of my Super Hero Doctorji R. Balasubramaniam 🙏🏻 Apart from being a empathetic human being, Doctorji’s exceptional care and meticulous attention to detail and commitment to excellence is truly inspiring and has actually accelerated my recovery to lead a normal life. Thankyou for giving me a second chance to Health and Happiness 🤩
Post surgery care also was so very seamless and highly commendable.This would not have been possible without the humongous dedication of Dr Balaji, Dr. Swaminathan, Dr Anu, Dr. Jeevagan whom we could reach out to 24*7 and they always stood by us like our pillars of support. Our whole family is ever indebted to the whole Nephro team, including the Dialysis team, especially Nivasan Sir who sensitised us about the legal format and ensured a hassle-free procedure.
Kauvery Hospital offers the best State of Art Technology combined with Accomplished Doctors and considerate support staff.
Really, I am living a DREAM 😍
Mrs Soni
I was affected by diabetes and took treatment at Pudukkottai and Trichy. Two years back my creatinine raised to a level of 7. Hence I started dialysis at Muthumeenakshi Hospital, Pudukkottai. Since my BMI was very high doctors at Pudukottai said it’s high risk and suggested to go to Chennai. My transplant was denied by many renowned transplant hospitals because of the high risk.
As per my friends recommendation I came to Vadapalani Kauvery Hospital and met Dr.Prabu Kanchi who is nephrologists of the Hospital. After making conversation he gave hope to me for my transplantation of kidney in very safe manner. I have also met the Surgery doctor Dr Swaminathan Sambantham through Dr.Prabu Kanchi. He is behaved in a very soft manner and given 100% guarantee for my kidney transplantation in a successful manner. Further he advised me get the transplant done with Robotic surgery. Kidney transplantation through Robotic technique was done by the team of doctors under the head of Dr.Swaminathan Sambandam and Dr.Prabu Kanchi. The mode of treatment and surgery done by Dr.Swaminathan Sambandam and Dr.Prabu Kanchi and other doctors are highly appreciable and done the surgery with utmost care and in good manner.
Dialysis centre is very neat and hygienic and staffs are very kind and gave high cooperation.
Finally I can say I gave rebirth in the world with kind treatment of doctors like (1) Dr.Swaminathan Sambandam (2) Dr.Prabu Kanchi, and other group of doctors. The doctors whose names were stated above are just like a treasure given to Kavery Group of Hospitals. Further the cost of treatment is comparatively less with that of other Hospitals. Once again I thank to all the team of doctors and the head of Dr.Swaminathan Sambandam and the Dr.Prabu Kanchi, Coordinator Sugendran, Harshini and Immanuvel and other staffs of the hospital.
Mr.Murugappan, B.Sc., B.L., Advocate & Notary Public and Commissioner of Oaths and practicing at Pudukkottai District and Trichy District.
