Mayo Clinic performs first ever robot-assisted kidney transplant

CATHARINE RICHERT: I'm Catharine Richert in for Cathy Wurzer. Next week will be a full circle moment for Mayo Clinic-- the 60th anniversary of the clinic's first kidney transplant from a living donor. And recently, the clinic performed its first robot-assisted kidney transplant. On October 4, a woman in her 60s received a kidney from her daughter.

WOMAN: It was probably about, if I had to guess, a month before surgery and said, hey, let me ask you, would you be willing to-- we're trying to do this robotically. And he said, I've been practicing a lot, and would you be willing to be our first patient to do this? And, of course, I hesitated and thought, hmm. And I said, what's the advantage to me to do this? And he said, well, you'll have smaller incisions, and so you'll have a quicker recovery. And I thought, well, I'd go for that.

CATHARINE RICHERT: Joining us now is Dr. Timucin Taner, the division chair of transplant surgery at Mayo Clinic. Thanks for being with us, Dr. Taner.

DR. TIMUCIN TANER: Oh, thanks for having us, Catharine.

CATHARINE RICHERT: So tell us what it means for the transplant to be robot-assisted. What does that look like?

DR. TIMUCIN TANER: This is a new technology, Catharine, that we are adopting. And just due to the nature of our state, we're in the forefront of this. Typically, a kidney transplant is an open surgery. It's a very successful surgery. We do a incision in the lower half of the abdomen to implant the kidney that's been donated. So, instead of this, now with the assistance of the robotic instruments, we're able to do this through a smaller incision in an alternative site, so with the potential benefit of patients recovering quicker, speedy recovery, and less discomfort in their incision sites.

CATHARINE RICHERT: When people imagine a robot, they might imagine something that looks like a human. But that is not what we're talking about, right? Are you in a different room when the surgery is being performed? Is it reliant more on computers?

DR. TIMUCIN TANER: Yeah. So that's exactly-- a lot of people imagine this as a human-like robot. It's not. It's just a robot that has a lot of arms that can do surgical parts-- some parts of the surgical procedure, with us being in the room but just operating a little distantly from the patient. So we're not touching the patient, but we're in the same room and controlling the robot ourselves.

CATHARINE RICHERT: So what did it take to get this robot into the clinic? What is the process before it was approved to be used on a patient?

DR. TIMUCIN TANER: Robotic surgery is now a standard offering for a lot of surgeries. So it's just new in transplant, but it's been used in other areas of surgery. So there is a precedent for that. And specifically, for training purposes, this requires about at least six months of training at different levels to get the same comfort level that we would in an open surgery. So it took our division about six months of training before this happened in our patient.

CATHARINE RICHERT: What other surgeries has the robot-assisted surgery been used on before-- what other common surgeries might people know about?

DR. TIMUCIN TANER: Yeah. The most common surgeries that are done robotically are some urologic procedures, like prostate surgery, some of the gynecological surgeries that happen in the pelvis. And this is the same thought in transplant as well. Most our listeners may not know, but when we do a kidney transplant, kidney goes into the pelvis. So we don't implant the kidney back into where it originally is, but it goes to a different slot. And robotic assistance really helps with that so we can do this through a smaller incision and have successful outcomes.

CATHARINE RICHERT: I did not know that. So what are the benefits to the patient in using this type of technology?

DR. TIMUCIN TANER: Yeah, Catherine. So, first of all, the open surgery is still a gold standard. It's got a lot of precedent. As I said, we've been doing kidney transplants for about 70 years now. But robotic assistance will help a certain number of patients who might benefit from this kind of an approach, and these patients are those that have a higher body mass index, those who had had incisions or surgeries in the lower abdomen in the past with the scar tissue that's associated with it, or people who have had hernias in that area.

CATHARINE RICHERT: And would it also lower the risk of infection too potentially?

DR. TIMUCIN TANER: Yeah, potentially, it'll lower the incidence of infection. Again, as we have to go through a scar tissue in a patient who had had multiple incisions or hernias in that area, that comes with the risk of having a higher incidence of infection. So if we have-- if we can do this through a different incision, that will certainly decrease the risk of infection.

CATHARINE RICHERT: So what are the risks associated with a robot-assisted surgery?

DR. TIMUCIN TANER: So the risks of this surgery are not any higher than the risks of doing an open surgery. Like any surgical procedure, the risks of bleeding, infections. But we know, from the other studies and from the use of robot in other areas that I mentioned before, that the risk is not any higher than it would be otherwise.

CATHARINE RICHERT: Now, what-- is this something you'll be using for every kidney transplant in the future? I mean, it sounds like we're still sort of in a world where the open surgery is standard, but could you see that changing down the road?

DR. TIMUCIN TANER: I think this will be used in, I would say, a percentage of patients. In most patients who don't have the risk factors that I've talked to you about before, I don't think we would need to use the robot. But it will certainly help us perhaps do a few more transplants and definitely decreasing the risk of complications that could happen in open surgeries in patients who have these risk factors.

CATHARINE RICHERT: So since we're looking forward on this, I'm also wondering if this technology could be used in other procedures. You've named a few where it was previously being used. This is new for Mayo Clinic. What other procedures do you think this would have a positive impact on down the road?

DR. TIMUCIN TANER: This could have a positive impact on donation as well. Again, just to call a shout-out, we can't do what we do without the donors, either deceased or living donors. And this might help do the living donor kidney operations as well as the living donor liver transplant operations as we go forward and as we learn more about these technologies.

CATHARINE RICHERT: So how do you reassure people? Maybe you've had patients come to you who say, I don't want to be near a robot during any medical procedure. What do you say to them?

DR. TIMUCIN TANER: Well, we explain to them what the robot is. As you said before, some people imagine the robot will be an independent, autonomous, human-like machine, and we just tell them that it's not the case. It's just the surgeon operating with the assistance of the robotic arms. It just helps with the precision. It helps with the recovery a little bit. So once people hear this, hear the actual facts, then usually they are very eager to proceed with this.

CATHARINE RICHERT: That was Dr. Timucin Taner. He is the division chair of transplant surgery at Mayo Clinic. Thank you for being with us today, Dr. Taner.

DR. TIMUCIN TANER: Thank you very much, Catharine.