Minimally Invasive Robotic Kidney Transplantation for Obese Patients Previously Denied Access to Transplantation

摘要: Epidemiological data indicate that 20-50% of patients on dialysis for end-stage renal disease (ESRD) are obese (body mass index [BMI] ≥30 kg/m2) (1). Obese with chronic failure have longer wait times until kidney transplantation (2) and inferior patient outcomes (3-7). In the US, example, a BMI 40 kg/m2 (2). Higher BMIs in transplant recipients associated excess risk surgical site infections (SSIs), which negatively impact graft survival (8). Obesity is also comorbidities such as diabetes, although whether obesity increases mortality transplanted remains unclear (8,9). Provider perceptions these risks accompanied by expectation some centers to give time lose weight main reasons why number reluctant list (2,10). Unfortunately, many diabetes hypertension likely secondary their (11) who remain very high rate. The 5-year rate diabetic hypertensive 75 70%, respectively (1). A recent study demonstrated did not present any SSIs had same success normal If procedures could be developed prevent demonstrate successful outcomes, may become less transplantation. Although benefit would still weighed against potential increased from obesity-related comorbidities. prevalence ESRD higher among racial ethnic minority populations, including African-Americans Hispanics, compared Non-Hispanic whites (12-15). These observations suggest developing options help reduce health disparities minorities. We therefore new, minimally invasive, robotic-assisted method using short epigastric incision. This avoids incision infection prone lower quadrants abdomen. We hypothesized priori robotic approach improve patients. Herein, we our experience undergoing minimal at single institution underwent conventional open procedure.