Excluded from kidney transplantation due to severe obesity, 2 patients were transplanted using a surgical robot. This first in Europe took place in Toulouse.
Started last summer, the robot-assisted kidney transplant continues to develop at the Toulouse University Hospital. At the controls of the robot’s console, Dr Nicolas Doumerc, urological surgeon.
And in a press release published this Friday, the establishment congratulates this expert in robotic surgery from the Department of Urology-Andrology and Renal Transplantation at Rangueil Hospital. This doctor is behind the first robot-assisted kidney transplant in obese patients in Europe.
Patients normally not eligible for transplantation because of their severe or morbid obesity. They have about 40% more risk of postoperative complications, explained to Agence France Presse (AFP) Dr Nicolas Doumerc. “In an important obese, explains the specialist, the thickness of the abdominal wall greatly increases the risk of postoperative infections and eventration. The use of a robot, which passes through the wall, avoids opening the stomach and only requires a small incision of 4 cm ”. This operation had so far only been performed at Chicago University Hospital where 67 obese patients have been transplanted since 2011.
And the list of benefits for them is still long: reduced pain and the risk of lymph fluid effusion, decreased average length of stay, etc.
Other feats to come
One month apart, the Toulouse University Hospital therefore performed this transplant on two patients with particularly severe obesity: 105 kg, 1.63 m, BMI at 37 for the first and 130 kg, 1.80 m, BMI at 40 for the second.
Interventions that have been successfully concluded thanks to a chain of medical and surgical collaboration. It starts with Prof. Nassim Kamar (head of the Department of Nephrology and Kidney Transplantation) who assessed the medical feasibility of this innovative transplant in the case of obesity, and continues with Dr Federico Sallusto, urological surgeon, coordinator of renal transplantation at the Toulouse University Hospital, which gave the surgical green light, taking into account the associated pathologies of patients.
Finally, Dr Nicolas Doumerc took control of the robot to transplant and brilliantly finished the work. “The Toulouse University Hospital is thus at the forefront of robotic surgery in renal transplantation for obese patients but also in kidney surgery excluding transplantation for the same type of patient. Recently, a robot-assisted nephrectomy for kidney cancer was performed on a patient weighing 205 kg for 1.79 m and a BMI of 64 ”, writes the establishment.
But the pace of operations can accelerate. The Toulouse University Hospital regrets that since 2010, “only 300 patients in the world (particularly in India and the USA) have been able to benefit from this type of transplantation, including 30 in Europe, mainly in Spain and France, notably in Toulouse. », He concludes.
Last year, the Toulouse University Hospital also performed the world’s first robot-assisted kidney transplant with extraction of the donor’s kidney and introduction of the graft on the recipient vaginally.
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