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Robotic Kidney Transplantation at Yale Shares Life, Learning

October 05, 2020
by Cecelia Smith

Yale Medicine’s multi-disciplinary transplantation team performed its seventh robotic assisted kidney transplant on September 22, following a seven-month hiatus, resulting from COVID pandemic restrictions. Yale New Haven Hospital became the first institution in New England to complete a robotic kidney case last October; the program was the sixth in the nation to have completed more than five of the novel surgical procedure.

“It’s a really incredible thing to be involved in because it is such a unique skillset. The surgeons who do successfully implement the programs then become teachers for the rest of us,” said Dr. Danielle Haakinson, who leads the program.

Dr. Haakinson has the support of fellow Yale Medicine surgeon, Dr. David Mulligan, and a dedicated team of nurses and surgical technologists — all of whom trained for the discipline over the course of a year-long training partnership with colleagues at the University of Illinois at Chicago, under the leadership of UIC Chair of Surgery, Dr. Enrico Benedetti. A prominent leader in robotic surgical technology in transplantation, Dr. Benedetti and his team were the first in the world to perform a robotic kidney transplantation.

The technique, which requires a comparatively small incision, is of particular benefit to obese patients, who present technical challenges intra-operatively and are at increased risk of post-operative complications and wound infection.

“For morbidly obese individuals, kidney transplant isn’t always an option, because the guidelines around body mass index are oftentimes restrictive,” Dr. Danielle Haakinson added.

Many transplant centers have BMI thresholds as relative contraindications to transplantation. At Yale, the threshold for eligibility among kidney transplant candidates has been a BMI of 40. The program at Yale currently allows for adult patients with a BMI above 28 to begin the robotic assisted kidney transplantation evaluation process. Dr. Haakinson has transplanted five men and two women to date, all with excellent graft outcomes and no wound infections. The heaviest patient had a BMI of 42.

“This approach allows us to provide better care to a more diverse patient population. Plus, we get the unique opportunity to learn from and teach our surgical colleagues across the country,” Dr. Haakinson said.

The Yale team has a goal to complete 15 robotic assisted kidney transplantations by May 2021. They are developing in partnership with UIC a national course for training the next generation of surgeons through the American Society of Transplant Surgeons (ASTS).

Submitted by Cecelia Smith on October 05, 2020