Cleveland Clinic is the first in the world to perform a single-port robotic kidney transplant

Single-incision robotic surgery may reduce morbidity and recovery time for patients.

November 2019, CLEVELAND: Cleveland Clinic is the first hospital in the world to successfully perform a single-port robotic kidney transplant, which allows all the surgical instruments and the donor kidney to be placed through one small abdominal incision.

The surgical team at Cleveland Clinic’s Glickman Urological & Kidney Institute included Jihad Kaouk, M.D., director of the Center for Robotic and Image-Guided Surgery; Alvin Wee, M.D., surgical director of kidney transplantation; Mohamed Eltemamy, M.D.; David Goldfarb, M.D.; and Eric Miller, M.D. These surgeons combined their collective expertise in minimally invasive, robotic and kidney transplant surgery to successfully complete the operation in October.

Dr Kaouk and his team were the first in the country to successfully perform a single-port robotic prostatectomy and kidney cancer surgery in September 2018. This latest surgical technique provides evidence that the single-port approach is feasible not only for cancer patients but also for patients who need a kidney transplant.

“The goal was not only to make a smaller incision, but also to minimise the area in which the operation was performed by limiting the number of cuts inside the patient,” said Dr Kaouk. “This resulted in minimal post-operative pain, and no opioids were needed after surgery.”

The single-port robotic platform may provide an alternative for suitable patients, including those with obesity or difficult anatomy. During the operation, the surgical team made a small four-centimetre incision in the patient’s abdomen. The surgeon then used the single-port robot to prepare the site for the donor kidney, connect the blood vessels and finally reconstruct the urinary drainage, before closing the incision.

“The single-port robotic approach is very promising,” said Dr Wee. “We look forward to continuing to refine this technique, and our team is optimistic about what this minimally invasive surgery can add to our range of kidney transplant options.”

Emilio Poggio, M.D., medical director of the Kidney Transplant Program, said: “Kidney transplantation remains the best treatment option for patients with end-stage kidney disease and is a very dynamic field where innovation offers new opportunities for personalised care. As such, this first single-port robotic kidney transplant adds a cutting-edge practice to the care of these patients.”

Georges Haber, M.D., chair of urology at the Glickman Urological & Kidney Institute, said: “A kidney transplant is a life-changing event for patients, many of whom have seen their quality of life suffer from having to undergo dialysis three times a week while waiting for a donor. This technique allows patients to regain their quality of life more quickly. Using the most advanced technology to help our patients live full lives is the true spirit of innovation we foster in the urology department at Cleveland Clinic.”

Dr Kaouk is a paid spokesperson for Intuitive Surgical, Inc.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical centre that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based on the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 66,000 employees are more than 4,200 salaried physicians and researchers and 16,600 nurses, representing 140 medical specialties and subspecialties. Cleveland Clinic’s health system includes a 165-acre main campus near downtown Cleveland, 11 regional hospitals, more than 180 outpatient locations in northern Ohio – including 18 full-service family health centres and three health and wellness centres – and facilities in Weston, Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2018, there were 7.9 million outpatient visits, 238,000 hospital admissions and 220,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/CCforMedia. News and resources are available at newsroom.clevelandclinic.org.