A Cedars-Sinai surgeon recently performed the medical center's first fully robotic kidney transplant, paving the way for more patients to undergo the less invasive method, which results in less pain and faster healing for patients.

For nearly two years, the Cedars-Sinai Kidney Transplant Programhas been performing living-donor nephrectomies-the surgical procedure of removing a kidney from the donor-fully robotically, but, until now, the recipient procedure had not been robot-assisted.

"The stakes are quite a bit higher when it comes to putting a kidney in," said Justin Steggerda, MD, who performed the Comprehensive Transplant Center's first fully robotic kidney transplant. "The risk of bleeding increases because you're not just cutting and stapling vessels but actually opening them up and sewing them together to get the transplanted kidney positioned well to where it can be reperfused and maintain good blood flow."

Cedars-Sinai is one of only a handful of institutions in the United States to have performed a fully robotic kidney transplant, placing it on the leading edge of transplant innovation.

Steggerda recently spoke with the Cedars-Sinai Newsroom about robotic kidney transplantation and who can benefit from the minimally invasive surgery.

How is robotic transplant surgery helpful to patients?

The primary advantage of a robotic approach is a smaller incision, which means less pain and lower risk of infection. This leads to a faster recovery, faster return to work and reduced reliance on pain medication. These are all big advantages for patient-centered outcomes.

There is a misconception that robots are doing the surgery itself, and that is not true. Robots do not act autonomously. We are controlling them every step of the way, so, in fact, it may be more appropriate to refer to it as robot-assisted surgery. But the advantage of using the robot is that the instruments can be much more dexterous, allowing the procedure to be more minimally invasive.

How does the incision for robotic surgery compare to a traditional procedure?

A kidney is about the size of a human fist, so any incision needs to be at least wide enough to get the organ in. For a robotic procedure, that incision is approximately the length of my palm. In a standard, open procedure, the incision is wider-closer to the length of my entire hand-so you can not only get the kidney in, but you can also see around it and get your instruments in to complete the operation.

What are the risks associated with robotic kidney transplant?

The biggest challenge of a robotic transplant procedure is getting into the abdomen safely and operating around other organs that may be in the way. This is different from a traditional, open procedure. … In a robotic transplant, we must be cognizant of the other organs that may be in our operative field, making the procedure more highly specialized.

Who will benefit most from robotic transplant procedures?

Patients with a body mass index over 35 or 40, are at an increased risk for wound infections, which have been associated with worse kidney transplant outcomes in the long term. By reducing some of those risks, we expect to see better outcomes in that population of patients.

What is next for the robotic transplant program?

Robotic kidney transplant at Cedars-Sinai is a program that we want to continue to grow. It will allow us to expand the number and types of patients that we transplant, with better outcomes. It's really the future of transplantation in general.

It's important to note, however, that we are working with a fragile population with end-stage kidney disease, and robotic surgery may not be the right technique for every patient. We will always evaluate every case individually to make sure we personalize the best possible care for each patient. In the short, three-to-five-year view, we hope to be performing up to 40% of these transplant procedures robotically as we continue to drive innovation further and stay on the leading edge of kidney transplantation surgery.

Read more from Cedars-Sinai Stories and Insights: What Is Robotic Surgery? How It Works and When It's Used