Fortis Hospital Bannerghatta Road in Bangalore, India, has reached a significant milestone in the field of robotic surgery by successfully performing the world's first reported case of Robotic En-Bloc Kidney Transplant. This pioneering procedure involved transplanting both kidneys from a 13-month-old deceased donor weighing 7.3 kgs into a 30-year-old recipient weighing 50 kgs. The surgery, conducted on May 8th, 2023, represents a remarkable advancement in kidney transplantation, offering hope to patients with end-stage renal disease who rely on chronic dialysis.
The recipient, a 30-year-old man suffering from chronic renal failure and experiencing deteriorating health, urgently required a renal transplant. Fortis Bannerghatta Hospital received the opportunity to transplant the kidneys from a 13-month-old donor weighing 7.3 kgs, who unfortunately passed away due to choking. The recipient had been registered with Jeevasarthakathe in Karnataka and was assigned the kidneys according to the established norms.
Under the guidance of Dr. Mohan Keshavamurthy, Senior Director of Urology, Uro-Oncology, Uro-Gynaecology, Andrology, Transplant, and Robotic Surgery at Fortis Hospitals Bengaluru, a highly skilled multidisciplinary team of doctors from the Urology, Nephrology, and Anesthesiology departments performed the retrieval and transplant procedures concurrently in parallel operating theaters. The team demonstrated their expertise and precision throughout the four-hour surgery. Dr. Sreeharsha Harinatha, Additional Director of Urology, Uro-Oncology, Uro-Gynaecology, Andrology, Transplant, and Robotic Surgery at Fortis Hospital, Bannerghatta Road, highlighted the complexity of En-Bloc kidney transplantation, which involves transplanting both kidneys from a pediatric donor along with the vena cava and aorta into a single recipient. This innovative technique allows the transplanted kidneys to grow proportionately according to the recipient's body weight, resulting in the preservation of nephron mass unaffected by the disease that led to the initial renal failure. Over time, the transplanted kidneys' function improves, providing long-term life-enhancing benefits for the recipient.
Dr. Mohan Keshavamurthy explained the surgical details, emphasizing the critical nature of this groundbreaking transplant. Despite the donor weight slightly exceeding the established cutoff of 7 kilograms, the surgical team successfully performed the En-Bloc kidney transplant using a robot-enhanced laparoscopic technique. The surgery, conducted under general anesthesia and strict asepsis protocol to prevent infections, involved the deployment of the Da Vinci Xi Robotic platform. The robotic system accurately located the blood vessels in the pelvic area, after which the donor's kidneys were removed as part of multi-organ retrieval. The kidneys underwent Bench surgery, a process where kidneys are temporarily removed from the patient's body, repaired outside the operating room, and then implanted back. The transplanted kidneys were inserted into the recipient's abdomen using a special device called Dextrus. The surgery successfully connected the donor's blood vessels to the recipient's arteries and veins, and the ureters of the transplanted kidney were connected to the recipient's bladder using the reimplantation technique, all made possible by the robotic system's excellent magnification and dexterity.
Following the surgery, the patient received comprehensive care in the Surgical Intensive Care Unit. Anemia was managed by administering irradiated packed red blood cells, and immunosuppressive medications (Tacrolimus, Mycophenolate, and steroids) were used to prevent rejection of the transplanted kidney. The patient showed positive progress and was discharged 12 days after the surgery with normal creatinine levels.
Mr. Akshay Oleti, the Business Head of Fortis Hospitals, Bengaluru, expressed his excitement and pride in the team's extraordinary achievement. He emphasized Fortis Hospital's commitment to medical innovation and pushing the boundaries of what is possible. The successful completion of the world's first reported Robotic En-Bloc Kidney Transplant by the Urology and Nephrology team at Fortis Hospital Bannerghatta Road showcases their exceptional skills and dedication to advancing kidney transplantation techniques. This groundbreaking milestone provides new hope for patients with end-stage renal disease and opens up possibilities in utilizing marginal deceased donor kidneys in the field of organ transplantation.
Fortis Hospital Bannerghatta Road's achievement in performing the world's first reported Robotic En-Bloc Kidney Transplant represents a significant breakthrough in robotic surgery. This groundbreaking procedure offers hope to patients with end-stage renal disease, paving the way for future advancements in organ transplantation.