Robot-assisted kidney transplantation as a minimally invasive approach for kidney transplant recipients: A systematic review and meta-analyses

Background: Robot-assisted kidney transplantation (RAKT) has emerged as an alternative for kidney transplant recipients with the potential benefits of minimally invasive surgery. The aim of this systematic review and meta-analysis is to compare the clinical outcomes of RAKT with open kidney transplantation (OKT). Methods: MEDLINE, Embase, Web of Science and Cochrane databases were systematically searched. Baseline characteristics, intraoperative and postoperative outcomes were collected, as well as long-term renal function and data on graft and patient survival. Results: Eleven studies were included, which compared 482 RAKT procedures with 1316 OKT procedures. RAKT was associated with lower a risk of surgical site infection (Risk ratio (RR) = 0.15, p < 0.001), symptomatic lymphocele (RR = 0.20, p = 0.03), less postoperative pain (Mean difference (MD) =-1.38 points, p < 0.001), smaller incision length (MD =-8.51 cm, p < 0.001), and shorter length of hospital stay (MD =-1.69 days, p = 0.03) compared with OKT. No difference was found in renal function, graft, and patient survival. Conclusions: RAKT is a safe and feasible alternative to OKT with less surgical complications without compro-mising renal function, graft and patient survival.