Canada's first robotic surgery living donor kidney transplant

Dr. Max Levine

Congratulations to Dr. Max Levine for launching Edmonton's robotic surgery renal transplant program. This month he performed two robot-assisted kidney transplants. One case was for a patient had an autotransplant (removal of her own kidney and re-transplanted in a new location in her body) due to an intrinsic renal vein compression syndrome causing chronic pain. The second was a living donor transplant for a patient on dialysis who received a kidney from a loved one. The living donor kidney transplant is the first time this has been completed in Canada. These procedures were the first cases of Edmonton’s robotic kidney transplant program, which Dr. Levine has been working on starting for over a year. He attended a robotic kidney transplant masterclass in Belgium in November 2023 to become trained in this procedure and perform robotic renal surgery in his usual surgical practice, which helped hone skills in preparation for starting this program. The team had an expert surgeon from the U.S.A. (University of Maryland) come to observe and proctor the case to ensure a smooth first case.

Dr. Levine says, “The motivation for this program is that robotic kidney transplantation has evidence supporting it to greatly reduce wound dehiscence and infectious complications as well as lymphoceles in transplant patients. Instead of a large 10-15cm incision that cuts through several layers of abdominal wall muscles, the robotic approach allows a smaller 6-7cm incision that cuts no muscle to be used for inserting the kidney into the body along with small robotic port incisions to introduce the robotic instruments.” It will hopefully reduce the morbidity and complications for transplant patients who are at highest risk for these complications, he says. This will hopefully lead to lower post-transplant care costs to the system by avoiding re-admissions and re-operations for major wound issues.  It also reduces morbidity specifically in the obese population, so it has the potential to increase the number of patients who are eligible for transplantation who might otherwise be deemed ineligible with an open surgery approach.

Dr. Levine says, “The success of the program is really a reflection of our strong robotics program at the UofA, as well as the support provided by our OR nursing team lead (Ryan Amyotte) who was instrumental in the preparation for this case (which spanned several months prior to the surgery itself) as well as the support from surgical site leadership at the UAH and the renal transplant program as a whole. The next cases will likely be in the fall as we evaluate the early outcomes of the first few cases and work on improving case efficiencies for the future.”