Robot-assisted kidney transplantation in a morbidly obese patient with incisional hernia reconstruction and abdominoplasty: a case report.

Q4 Medicine Korean Journal of Transplantation Pub Date : 2023-09-30 Epub Date: 2023-08-11 DOI:10.4285/kjt.23.0021
Jin-Myung Kim, Hye Eun Kwon, Youngmin Ko, Joo Hee Jung, Hyunwook Kwon, Young Hoon Kim, Eun Key Kim, Sung Shin
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Abstract

Performing kidney transplantations in patients with morbid obesity presents unique challenges using the conventional retroperitoneal approach. Robot-assisted kidney transplantation (RAKT) offers several advantages, such as better access to hard-to-reach areas. A 56-year-old morbidly obese woman presented with end-stage renal disease due to diabetic nephropathy. The patient had a history of obesity for over 20 years, with a peak body mass index (BMI) of 46.9 kg/m2. Before transplantation, she successfully reduced her BMI to 28.9 kg/m2, but was left with excessive skin folds. The surgery began with the removal of the sac from the incisional hernia and umbilical hernia, which was then used as the site for the GelPOINT port. The da Vinci X robot system was utilized to perform RAKT. After completing RAKT, the plastic surgery team initiated abdominal reconstruction involving panniculectomy, followed by hernial reconstruction and abdominoplasty. The patient's postoperative course was uneventful, and she was discharged on postoperative day 7. Her creatinine level was 0.69 mg/dL, and she did not experience any episodes of rejection during the 16 months following RAKT. This case report describes the successful combination of RAKT with incisional hernia reconstruction and abdominoplasty in a patient with morbid obesity.

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机器人辅助肾移植治疗病态肥胖患者切口疝重建和腹部成形术:一例报告。
在病态肥胖患者中进行肾移植是使用传统腹膜后方法的独特挑战。机器人辅助肾移植(RAKT)提供了几个优点,例如更好地进入难以到达的区域。一位56岁的病态肥胖女性因糖尿病肾病而出现终末期肾病。患者有超过20年的肥胖史,峰值体重指数(BMI)为46.9 kg/m2。移植前,她成功地将体重指数降至28.9 kg/m2,但留下了过多的皮肤褶皱。手术开始于从切口疝和脐疝中取出疝囊,然后将其用作GelPOINT端口的位置。使用da Vinci X机器人系统进行RAKT。完成RAKT后,整形外科团队开始了包括脂膜切除术在内的腹部重建,然后是疝重建和腹部成形术。患者术后进展顺利,于术后第7天出院。她的肌酸酐水平为0.69 mg/dL,在RAKT后的16个月内没有出现任何排斥反应。本病例报告描述了RAKT与切口疝重建和腹部成形术在一名病态肥胖患者中的成功结合。
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来源期刊
Korean Journal of Transplantation
Korean Journal of Transplantation Medicine-Transplantation
CiteScore
0.80
自引率
0.00%
发文量
32
审稿时长
24 weeks
期刊最新文献
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