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Robotic living donor nephrectomy is associated with reduced post-operative opioid use compared to hand-assisted laparoscopic approach.

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Title: Robotic living donor nephrectomy is associated with reduced post-operative opioid use compared to hand-assisted laparoscopic approach.
Authors: Kiani, Amen Z.1,2 amen@wustl.edu, Progar, Kristin3, Hill, Angela L.1, Vachharajani, Neeta1, Olumba, Franklin1, Yu, Jennifer1, Chapman, William C.1, Doyle, Majella B.1, Wellen, Jason R.1, Khan, Adeel S.1
Source: Surgical Endoscopy & Other Interventional Techniques. Jul2024, Vol. 38 Issue 7, p3654-3660. 7p.
Subject Terms: *SURGICAL robots, *ORGAN donors, *PATIENTS, *TRANSPLANTATION of organs, tissues, etc., *T-test (Statistics), *PATIENT safety, *LAPAROSCOPIC surgery, *FISHER exact test, *NEPHRECTOMY, *TREATMENT effectiveness, *RETROSPECTIVE studies, *DESCRIPTIVE statistics, *OPIOID analgesics, *PAIN management, *POSTOPERATIVE period, *COMPARATIVE studies, *LENGTH of stay in hospitals
Abstract: Background: Robotic donor nephrectomy (RDN) has emerged as a safe alternative to laparoscopic donor nephrectomy (LDN). Having previously demonstrated comparable efficacy, this study aims to examine postoperative analgesia use (opioid and non-opioid) in the two groups. Methods: We conducted a retrospective review of 300 living donor nephrectomies performed at our center, comparing 150 RDN's with a contemporary cohort of 150 hand-assisted LDN's. In addition to clinical and demographic information, data on postoperative inpatient opioid and non-opioid analgesia (from patient's arrival to the surgical floor after surgery till the time of discharge) was collected. Opioid dosages were standardized by conversion to morphine milligram equivalents (MME). All patients were managed post-operatively under a standardized ERAS pathway for living donor nephrectomy patients. Results: There were no significant differences in donor age, gender, and BMI between RDN and LDN groups. Total post-operative opioid use (MME's) was significantly lower in RDN patients (RDN 27.1 vs. LDN 46.3; P < 0.0001). Breakdown of opioid use with post-operative (POD) day demonstrated significantly lower use in RDN group on POD1 (RDN 8.6 vs. LDN 17.0; P < 0.05), and POD2 (RDN 3.9 vs LDN 10; P < 0.05). RDN patients had a shorter post-operative length of stay (LOS) (RDN 1.69 days vs. LDN 1.98; P = 0.0003). There were no differences between groups in non-opioid medication use, complications, and readmission rates. Conclusion: RDN has comparable safety to hand-assist LDN and offers additional benefits of lower postoperative opioid requirement and a shorter hospital LOS. [ABSTRACT FROM AUTHOR]
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  Data: Robotic living donor nephrectomy is associated with reduced post-operative opioid use compared to hand-assisted laparoscopic approach.
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– Name: Abstract
  Label: Abstract
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  Data: Background: Robotic donor nephrectomy (RDN) has emerged as a safe alternative to laparoscopic donor nephrectomy (LDN). Having previously demonstrated comparable efficacy, this study aims to examine postoperative analgesia use (opioid and non-opioid) in the two groups. Methods: We conducted a retrospective review of 300 living donor nephrectomies performed at our center, comparing 150 RDN&#39;s with a contemporary cohort of 150 hand-assisted LDN&#39;s. In addition to clinical and demographic information, data on postoperative inpatient opioid and non-opioid analgesia (from patient&#39;s arrival to the surgical floor after surgery till the time of discharge) was collected. Opioid dosages were standardized by conversion to morphine milligram equivalents (MME). All patients were managed post-operatively under a standardized ERAS pathway for living donor nephrectomy patients. Results: There were no significant differences in donor age, gender, and BMI between RDN and LDN groups. Total post-operative opioid use (MME&#39;s) was significantly lower in RDN patients (RDN 27.1 vs. LDN 46.3; P &lt; 0.0001). Breakdown of opioid use with post-operative (POD) day demonstrated significantly lower use in RDN group on POD1 (RDN 8.6 vs. LDN 17.0; P &lt; 0.05), and POD2 (RDN 3.9 vs LDN 10; P &lt; 0.05). RDN patients had a shorter post-operative length of stay (LOS) (RDN 1.69 days vs. LDN 1.98; P = 0.0003). There were no differences between groups in non-opioid medication use, complications, and readmission rates. Conclusion: RDN has comparable safety to hand-assist LDN and offers additional benefits of lower postoperative opioid requirement and a shorter hospital LOS. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Surgical Endoscopy &amp; Other Interventional Techniques is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder&#39;s express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00464-024-10925-5
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        Text: English
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    Subjects:
      – SubjectFull: SURGICAL robots
        Type: general
      – SubjectFull: ORGAN donors
        Type: general
      – SubjectFull: PATIENTS
        Type: general
      – SubjectFull: TRANSPLANTATION of organs, tissues, etc.
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      – SubjectFull: FISHER exact test
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      – SubjectFull: NEPHRECTOMY
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      – SubjectFull: TREATMENT effectiveness
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      – SubjectFull: RETROSPECTIVE studies
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      – SubjectFull: DESCRIPTIVE statistics
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      – SubjectFull: OPIOID analgesics
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      – SubjectFull: PAIN management
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      – SubjectFull: POSTOPERATIVE period
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      – SubjectFull: LENGTH of stay in hospitals
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      – TitleFull: Robotic living donor nephrectomy is associated with reduced post-operative opioid use compared to hand-assisted laparoscopic approach.
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              Text: Jul2024
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