Authors (including presenting author) :
Wong Ting Fung, Wong Hoi Lung, Tsang Chiu Fung, Ma Kam Man Maggie, Ho Sze Ho Brian, Hung Pui Long Wilson, Lai Chun Ting Terence, Lie Hong Yin Henry, Mak Siu Yip Martin, Chang Tsz Paak, Tsang Shek Long, Ng Tsui Lin Ada
Affiliation :
Queen Mary Hospital
Keyword 1: :
Robotic-assisted kidney transplantation
Keyword 2: :
minimally invasive surgery
Keyword 4: :
initial experience
Keyword 5: :
graft function
Introduction :
Robotic-assisted kidney transplantation (RAKT) is a minimally invasive alternative to open surgery, offering advantages such as enhanced precision, reduced surgical trauma, and faster recovery. The technique is well-established in select centres worldwide and is particularly valuable in high-density urban settings where efficient resource utilization is essential. Prior to this series, however, RAKT had not been performed in Hong Kong. We hereby present the region’s first clinical experience with this advanced surgical approach.
Objectives :
The aim of this report is to describe the surgical technique, feasibility, and short-term outcomes of the first three RAKT procedures performed in Hong Kong. Primary outcome measures included operative duration, warm ischemia time, perioperative complications, and initial graft function, with the goal of evaluating the safety and efficacy of RAKT in a local clinical setting.
Methodology :
In December 2025, the first three RAKT procedures were performed at Queen Mary Hospital using the da Vinci Xi platform. Recipients (two male, one female) had end-stage renal disease and received living-related donor kidneys. The surgical technique included an intraperitoneal approach, robotic vascular anastomosis, and ureteroneocystostomy. A continuous intracorporeal irrigation system with cold HTK solution was used to minimize graft ischemia. Primary outcomes were surgical feasibility, operative times, ischemia time, perioperative complications, and initial graft function.
Result & Outcome :
All procedures were completed robotically without conversion to open surgery. Mean total operative time was 217 minutes, with mean arterial and venous anastomosis times of 22.0 and 22.3 minutes, respectively. Through continuous cold irrigation, graft ischemia during the recipient operation was effectively minimized. Estimated blood loss was < 100 mL in all cases, with no intraoperative complications. All grafts functioned immediately upon reperfusion, with mean serum creatinine levels of 247 µmol/L on postoperative day 3 and 160 µmol/L on day 7. Patients were mobilized on postoperative day 1 and discharged with excellent graft function and no surgical complications. Conclusion: This initial series demonstrates that robotic-assisted kidney transplantation is feasible, safe, and effective in the Hong Kong setting, with operative and early functional outcomes aligning with international standards. RAKT represents a significant advance in minimally invasive transplant surgery for local patients and establishes a new standard of care. These cases provide a foundation for a structured robotic transplant program, warranting further long-term follow-up and prospective studies.
