Robotic-assisted kidney transplant and weight loss surgery can be performed safely for obese patients

A kidney transplant is usually denied to sufferers who’re overweight on account of an elevated danger of surgical issues, notably infections. Surgeons at UI Heath — the scientific and tutorial well being enterprise of the College of Illinois Chicago — have pioneered the usage of robotic-assisted surgical procedure for kidney transplants in overweight sufferers to efficiently scale back surgical issues. The process has opened up a life-saving door to sufferers who would in any other case be caught on dialysis to deal with their kidney illness, which carries its personal severe dangers.

The UIC workforce, led by Dr. Enrico Benedetti, professor and Warren H. Cole Chair of Surgical procedure, has proven that robotic-assisted kidney transplant and weight reduction surgical procedure might be carried out safely. Their outcomes are printed within the American Journal of Transplantation.

Weight problems is a significant danger issue for kidney illness. Performing robotic-assisted weight reduction surgical procedure along with kidney transplant is the logical subsequent step as a result of with one surgical procedure, we give the transplant a greater shot at success as a result of the burden loss the affected person will expertise helps enhance cardiac operate and scale back stress on the brand new organ.”

Dr. Pierpaolo Di Cocco, assistant professor of surgical procedure at UIC and co-author of the paper

“With this simultaneous surgical method, we will deal with end-stage kidney illness weight problems — a significant participant in kidney illness — on the similar time with a single operation and a single course of anesthesia,” stated Dr. Tzvetanov, affiliate professor of surgical procedure, chief of transplantation and a co-author on the paper.

Weight problems is taken into account a worldwide epidemic, in response to the World Well being Group. By 2030, the variety of chubby and overweight people worldwide is projected to succeed in 2.16 billion and 1.12 billion, respectively.

Weight problems is a significant danger issue for heart problems and diabetes, which in flip impacts the development of power kidney illness. Typically sufferers are handled with dialysis for years earlier than they obtain a kidney transplant, which stays the most effective remedy for end-stage kidney illness. However for sufferers with weight problems, a kidney transplant will not be authorised.

Sleeve gastrectomy is a process that reduces the scale of the abdomen by roughly 75% and is without doubt one of the commonest weight-loss surgical procedures.

Di Cocco and colleagues enrolled 20 sufferers into the examine between 2012 and 2019. On common, sufferers had physique mass indices, or BMI, of 44. A BMI of 30 or above is indicative of weight problems.

Eleven sufferers obtained a robotic-assisted kidney transplant and sleeve gastrectomy and 9 sufferers obtained robotic-assisted kidney transplantation alone.

All sufferers obtained weight-loss training and took part in a medically supervised weight reduction program, which consisted of train and weight-reduction plan suggestions in addition to visits with a multidisciplinary workforce of bariatric surgeons, nurse practitioners, medical consultants, dietitians, psychologists and train physiologists.

Sufferers who underwent each procedures have been underneath anesthesia roughly 1 hour longer than those that underwent kidney transplantation alone. Two sufferers within the kidney transplant group skilled organ rejection at one yr and three years post-surgery. No sufferers within the kidney-transplant-plus-sleeve-gastrectomy group skilled organ rejection.

A yr after the surgical procedure, BMI dropped a mean of 9 factors within the group who obtained the mixed robotic sleeve gastrectomy and robotic-assisted kidney transplants. The transplant-only group gained a mean of two factors. Sufferers within the dual-procedure group skilled a 50% drop in extra weight, roughly.

“Whereas it’s encouraging that sufferers can safely bear each robotic-assisted kidney transplant and weight reduction surgical procedure safely, it’ll take extra follow-up time for us to grasp all of the potential advantages of this process,” Tsvetanov stated.