Lessons from transplantation surgery applied to general urology

Thematic Session 09

  • Location:
    Room London (Hall B2, level 0)
  • Chair:
     L. Peri Cusi, Barcelona (ES)
  • Aims and objectives of this session

    Kidney transplantation benefits from urological surgical techniques and vice versa. The present session gives us three examples. Laparoscopic living donor nephrectomy, is a nephrectomy that should preserve the kidney anatomy carefully and needs to use a short warm ischemia time. Several issues related to safety in the management of the pedicle must be updated including, the debate on the use of hem-O-locks. Robotic surgery in urology was developed mainly in the field of radical prostatectomy. New indications have been developed, probably the most amazing one being complex reconstructive surgery such as kidney transplant. An open debate about their benefits and risks is taking place currently and during the session. Finally the most paradigmatic application of kidney transplant, autotransplantation, will be reviewed in order to define when to use it for severe urological disorders.

State-of-the-art lecture Laparoscopic living donor nephrectomy: Safety issues. How to best secure the pedicle?
 A.J. Figueiredo, Coimbra (PT)
Aims and objectives of this presentation

“Safety first” is nowhere as fundamental as in living donor nephrectomy. During surgery, the control of the pedicle is the one that encompasses the biggest danger.
The aim of this lecture is to provide a critical review of the different ways of controlling the pedicle.
It will include the presentation of the results of an online survey on the methods that urologists use to clamp the artery and on their position regarding the controversial use of "Hem-o-Loks" in this setting.

Debate Is robotic assisted transplantation the future?
Laparoscopic and robotic transplantation
 R. Ahlawat, Gurgaon (IN)
Aims and objectives of this presentation

Aim of the presentation is to present the basics of technique and the potential advantages of the minimally invasive approach. Like all other areas of surgery, minimally invasive approach is likely to prove its value in transplantation.

 E. Lledó García, Madrid (ES)
Aims and objectives of this presentation

Renal transplantation is the best treatment for end stage renal disease. Surgical technique has been established with excelent results since more than 40 years ago. The introduction of minimal invasive surgical techniques allowed recent advances, especiallly in the living donor nephrectomy process using laparoscopy. It seems important to show evidence about the cost-effectiveness and advantages of the robotic kidney transplant procedure at the same time that no worst functional outcome of both graft and patient nor increasing complications occur.

State-of-the-art lecture What urologists can learn from transplant surgeons
 F.J. Burgos Revilla, Madrid (ES)
Aims and objectives of this presentation

The aim of the presentation is to show technical details of kidney transplantation surgery that are useful for the general urologists to resolve different surgical challenges in conventional practice. Additionally techniques used for resolution of kidney transplant surgical complications are showed and translocated to conventional urologic settings.

Associated video abstract presentation
A new surgical area opened in renal transplantation: A pure robot-assisted approach for both living donor nephrectomy and kidney transplantation using transvaginal route

By: Doumerc N.1, Beauval J.B.2, Roumiguié M.2, Game X.2, Kamar N.3, Sallusto F.2, Soulié M.2, Rischmann P.2

Institutes: 1CHU Rangueil, Dept. of Urology, Toulouse, France, 2CHU Rangueil, Dept. of Urology, Andrology and Renal Transplantation, Toulouse, France, 3CHU Rangueil, Dept. of Nephrology and Renal Transplantation and Andrology, Toulouse, France

Aims and objectives of this presentation

To show a new way to perform a kidney transplantation using exclusively robotics for both donor and recipient.