Robotic-assisted kidney transplantation: Technical evolution and applications in complex scenarios

Jianchun Cui , Shuncheng Tan , Yonglin Song , Xun Sun

Current Urology ›› 2026, Vol. 20 ›› Issue (1) : 37 -43.

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Current Urology ›› 2026, Vol. 20 ›› Issue (1) :37 -43. DOI: 10.1097/CU9.0000000000000313
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Robotic-assisted kidney transplantation: Technical evolution and applications in complex scenarios
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Abstract

Robot-assisted kidney transplantation (RAKT) is a new, minimally invasive option for kidney transplantation with great application prospects. This narrative review aimed to outline the developmental history of RAKT, existing technology, and its application in different types of kidney transplant surgery. The challenges with RAKT and the solutions to those challenges in practical operation are analyzed as well, to provide reference for the application of robots in kidney transplantation.

Keywords

Robotic-assisted kidney transplantation / Minimally invasive surgical procedures / Technical evolution / Complex scenario / Indication

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Jianchun Cui, Shuncheng Tan, Yonglin Song, Xun Sun. Robotic-assisted kidney transplantation: Technical evolution and applications in complex scenarios. Current Urology, 2026, 20(1): 37-43 DOI:10.1097/CU9.0000000000000313

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The authors declare that they have no competing interests.

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References

[1]

Menon M, Sood A, Bhandari M, et al. Robotic kidney transplantation with regional hypothermia: A step-by-step description of the Vattikuti Urology Institute-Medanta technique (IDEAL phase 2a). Eur Urol 2014; 65(5):991-1000.

[2]

Hoznek A, Zaki SK, Samadi DB, et al. Robotic assisted kidney transplantation: An initial experience. J Urol 2002; 167(4):1604-1606.

[3]

Giulianotti P, Gorodner V, Sbrana F, et al. Robotic transabdominal kidney transplantation in a morbidly obese patient. Am J Transplant 2010; 10(6):1478-1482.

[4]

Boggi U, Vistoli F, Signori S, et al. Robotic renal transplantation: First European case. Transpl Int 2011; 24(2):213-218.

[5]

Kaouk J, Eltemamy M, Aminsharifi A, et al. Initial experience with single-port robotic-assisted kidney transplantation and autotransplantation. Eur Urol 2021; 80(3):366-373.

[6]

Musquera Felip M, Ajami Fardoun T, Peri Cusi L, Alcaraz Asensio A. Technique description and outcomes of robotic transvaginal-assisted living donor kidney transplantation. Urol Int 2021; 105(1-2):148-154.

[7]

Wang X, Zu Q, Zhu Q, et al. Surgical outcomes of robotic-assisted kidney transplantation in end-stage renal disease treatment (1 case report) (in Chinese). J Minimally Invasive Urol 2018; 7(3):159-162.

[8]

Breda A, Territo A, Gausa L, et al. Robot-assisted kidney transplantation: The European experience. Eur Urol 2018; 73(2):273-281.

[9]

Kishore TA, Kaddu DJ, Sodhi BS, Srinivasan SP, Unni NV. Robotic kidney transplant beyond the learning curve: 8-year single-center experience and matched comparison with open kidney transplant. Urology 2024;183:100-105.

[10]

Oberholzer J, Giulianotti P, Danielson KK, et al. Minimally invasive robotic kidney transplantation for obese patients previously denied access to transplantation. Am J Transplant 2013; 13(3):721-728.

[11]

Lee SD, Rawashdeh B, McCracken EKE, et al. Robot-assisted kidney transplantation is a safe alternative approach for morbidly obese patients with end-stage renal disease. Int J Med Robot 2021; 17(5):e2293.

[12]

Chen Y, Dabbas W, Gangemi A, et al. Obesity management and chronic kidney disease. Semin Nephrol 2021; 41(4):392-402.

[13]

Spaggiari M, Di Cocco P, Tulla K, et al. Simultaneous robotic kidney transplantation and bariatric surgery for morbidly obese patients with end-stage renal failure. Am J Transplant 2021; 21(4):1525-1534.

[14]

Spaggiari M, Petrochenkov E, Gruessner A, et al. Robotic kidney transplantation from deceased donors: A single-center experience. Am J Transplant 2023; 23(5):642-648.

[15]

Ploumidis A, Pappas A, Spinoit A, et al. Robot-assisted kidney transplantation in a child. First successful minimally invasive pediatric transplantation in Europe. Eur Urol Suppl 2018; 17(7):e2426.

[16]

Wu Y, Zhou H, Li P, et al. Pediatric robot-assisted kidney transplantation: An initial case report in China. ISURG 2023;6:82-85.

[17]

Pérez-Reggeti JI, Etcheverry B, Fiol M, et al. Robot-assisted kidney transplantation in patients undergoing cystectomy with urinary diversion: First cases reported by the ERUS-RAKT working group. Eur Urol Open Sci 2024;71:144-147.

[18]

Pein U, Girndt M, Markau S, et al. Minimally invasive robotic versus conventional open living donor kidney transplantation. World J Urol 2020; 38(3):795-802.

[19]

Kumar A, Sharma H, Chaturvedi S, et al. Innovative technique of reducing rewarm ischemia time in robotic assisted kidney transplant with multiple vessels. Eur Urol 2023;83:S1908.

[20]

Zafar F, Mallya A, Nataraj S, et al. Robotic kidney transplant using renal grafts with multiple renal arteries has outcomes comparable to grafts with single artery. Eur Urol Suppl 2019; 18(1):e1019.

[21]

Angell J, Abaza R. Completely intracorporeal robotic renal autotransplantation. Videourology (New Rochelle) 2013; 27(6). doi:10.1089/vid.2013.0041.

[22]

Eltemamy M, Garisto J, Miller E, Wee A, Kaouk J. Single port robotic extra-peritoneal dual kidney transplantation: Initial preclinical experience and description of the technique. Urology 2019;134:232-236.

[23]

Buelens S, Henckes M, Slots C, et al. VE18 first completely intracorporeal and extraperitoneal robot-assisted kidney autotransplantation with single port platform. Eur Urol Open Sci 2024;67:S157.

[24]

Chavali JS, Kaouk J, Soputro N, Eltemamy M. Single-port extraperitoneal robotic kidney transplantation: Early experience of novel technique. BJU Int 2025; 135(3):433-436.

[25]

Spaggiari M, Martinino A, Petrochenkov E, et al. Single-center retrospective assessment of robotic-assisted simultaneous pancreas-kidney transplants: Exploring clinical utility. Am J Transplant 2024; 24(6):1035-1045.

[26]

Ahlawat R. Robotic kidney transplantation under regional hypothermia. J Endourol 2022; 36(S2):S18-S24.

[27]

Menon M, Sood A, Bhandari M, et al. Robotic kidney transplantation with regional hypothermia: A step-by-step description of the Vattikuti Urology Institute-Medanta technique (IDEAL phase 2a). Eur Urol 2014; 65(5):991-1000.

[28]

Meier RPH, Piller V, Hagen ME, et al. Intra-abdominal cooling system limits ischemia-reperfusion injury during robot-assisted renal transplantation. Am J Transplant 2018; 18(1):53-62.

[29]

Tan S, Cui J, Song Y, et al. Preliminary experience in robot-assisted laparoscopic kidney transplantation (with 22 cases report). J Minim Invasive Urol 2021; 10(3):157-162.

[30]

Karadag S, Eksi M, Ozdemir O, et al. Comparison of open and robot-assisted kidney transplantation in terms of perioperative and postoperative outcomes. Int J Clin Pract 2022;2022:2663108.

[31]

Musquera M, Peri L, Ajami T, et al. Robot-assisted kidney transplantation: Update from the European Robotic Urology Section (ERUS) series. BJU Int 2021; 127(2):222-228.

[32]

Maheshwari R, Qadri SY, Rakhul LR, et al. Prospective nonrandomized comparison between open and robot-assisted kidney transplantation: Analysis of midterm functional outcomes. J Endourol 2020; 34(9):939-945.

[33]

Inci MF, Ozkan F, See TC, Tatli S. Renal transplant complications: Diagnostic and therapeutic role of radiology. Can Assoc Radiol J 2014;65:242-252.

[34]

O'Connor-Cordova MA, Ortega-Macias AG, Sancen-Herrera JP, et al. Living donor robotic-assisted kidney transplant compared to traditional living donor open kidney transplant. Where do we stand now? A systematic review and meta-analysis. Transplant Rev (Orlando) 2023; 37(4):100789.

[35]

Tzvetanov IG, Spaggiari M, Tulla KA, et al. Robotic kidney transplantation in the obese patient: 10-year experience from a single center. Am J Transplant 2020; 20(2):430-440.

[36]

Ahlawat RK, Tugcu V, Arora S, et al. Learning curves and timing of surgical trials: Robotic kidney transplantation with regional hypothermia. J Endourol 2018; 32(12):1160-1165.

[37]

Tan S, Cui J, Sun X, et al. Discussion on the learning curve of robot-assisted kidney transplantation. Organ Transplant 2024; 15(6):928-934.

[38]

Fan Y, Wang H, Zu Q, et al. Analysis of the learning curve of robotic kidney transplantation. J Minim Invasive Urol 2022; 11(3):150-155.

[39]

Pecoraro A, Andras I, Boissier R, et al. The learning curve for open and minimally-invasive kidney transplantation: A systematic review. Minerva Urol Nephrol 2022; 74(6):669-679.

[40]

Abaza R, Ghani KR, Sood A, et al. Robotic kidney transplantation with intraoperative regional hypothermia. BJU Int 2014; 113(4):679-680.

[41]

Jeong W, Abaza R, Sood A, et al. 1019 robotic kidney transplantation with regional hypothermia: Evolution of a novel procedure utilizing the IDEAL guidelines (IDEAL Phase 0 and 1). Eur Urol Suppl 2014; 13(1):e1019.

[42]

Zhang H, Zeng J, Fan Y, Ma M, Lin T, Song T. Continuous renal surface cooling technique (CSCT) in robotic-assisted kidney transplantation: Technique and outcomes from a high-volume center: A prospective cohort study. Int J Surg 2024; 110(7):4143-4150.

[43]

Doumerc N, Roumiguié M, Rischmann P, Sallusto F. Totally robotic approach with transvaginal insertion for kidney transplantation. Eur Urol 2015; 68(6):1103-1104.

[44]

Musquera Felip M, Ajami Fardoun T, Peri Cusi L, Alcaraz Asensio A. Technique description and outcomes of robotic transvaginal-assisted living donor kidney transplantation. Urol Int 2021; 105(1-2):148-154.

[45]

Spinoit AF, Moreels N, Raes A, et al. Single-setting robot-assisted kidney transplantation consecutive to single-port laparoscopic nephrectomy in a child and robot-assisted living-related donor nephrectomy: Initial Ghent experience. J Pediatr Urol 2019; 15(5):578-579.

[46]

Grammens J, Schechter MY, Desender L, et al. Pediatric challenges in robot-assisted kidney transplantation. Front Surg 2021;8:649418.

[47]

Bowen DK, Casey JT, Cheng EY, Gong EM. Robotic-assisted laparoscopic transplant-to-native ureteroureterostomy in a pediatric patient. J Pediatr Urol 2014; 10(6):1284.e1-1284.e12842.

[48]

Zhao J, Chen X, Fan Y, et al. Robot-assisted laparoscopic multi-branch artery renal transplantation. J Minim Invasive Urol 2021; 10(1):8-11.

[49]

Siena G, Campi R, Decaestecker K, et al. Robot-assisted kidney transplantation with regional hypothermia using grafts with multiple vessels after extracorporeal vascular reconstruction: Results from the European Association of Urology Robotic Urology Section Working Group. Eur Urol Focus 2018; 4(2):175-184.

[50]

Angell J, Abaza R. Completely intracorporeal robotic renal autotransplantation. Videourology 2013; 27(6). doi:10.1089/vid.2013.0041.

[51]

Decaestecker K, Van Parys B, Van Besien J, et al. Robot-assisted kidney autotransplantation: A minimally invasive way to salvage kidneys. Eur Urol Focus 2018; 4(2):198-205.

[52]

Breda A, Diana P, Territo A, et al. Intracorporeal versus extracorporeal robot-assisted kidney autotransplantation: Experience of the ERUS RAKT Working Group. Eur Urol 2022; 81(2):168-175.

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