UIC introduces robotic kidney transplantation surgery for obese recipients

Surgeons at the University of Illinois Medical Center at Chicago are the first to offer robotic kidney transplantation to morbidly obese patients and report fewer complications among this high risk population.

"We have been able to eliminate wound infections, pulmonary complications, and reduce the length of hospitalization for obese kidney transplant recipients using robotic-assisted surgery," said Dr. Enrico Benedetti, the Warren H. Cole Chair and head of surgery at UIC.

Wound infections lead to increased risk of graft loss in transplant recipients, and obesity is the main risk factor for superficial wound infection, said Benedetti.

In an abstract to be presented at the American Transplant Congress in May, Benedetti and colleagues report that robotic-assisted kidney transplantation eliminates wound infection (0 percent versus 15 percent in open surgery), pulmonary complications (0 percent versus 9 percent in open surgery) and length of hospitalization is reduced (5 days versus 8.5 days in open surgery).

In Illinois, UIC is the only transplant center that will accept renal failure patients with a body mass index (BMI) above 40 who are in need of kidney transplantation, according to Benedetti. Most of these patients have no other access to kidney transplantation and experience high mortality rates while on dialysis.

UIC surgeons have transplanted 13 morbidly obese patients since 2009 and report that all were successful, 100 percent patient and graft survival, with no complications. The team of surgeons includes Dr. Pier Cristoforo Giulianotti, head of robotic surgery, Dr. José Oberholzer, and Benedetti.

"Sometimes, minimally invasive surgery does not offer many advantages over open surgery, other than the cosmetic result of having a smaller incision. However, for morbidly obese kidney transplant recipients, the robotic technique developed at UIC by Drs. Giulianotti and Benedetti, not only offers a more cosmetic result, but is a true life saving procedure," said Oberholzer, who is chief of transplantation at UIC. "Today, we can perform very safely a kidney transplant in obese patients who otherwise would be condemned to remain on dialysis with little chance for long term survival."

Recently, two renal failure patients each with BMI over 50 underwent successful robotic kidney transplantation during a simultaneous paired exchange, or "swap" transplant, at the medical center.

The two patients, who were complete strangers, came to UIC for living-donor transplant evaluation, but their respective donors turned out not to be blood-type compatible. The transplant team approached the two recipients about swapping donors, and the surgery proved life-saving for both.