Objective: The aim of the study was to describe the surgical technique of totally robotic kidney transplantation with transvaginal insertion and to assess its safety and feasibility. Methods: It is a prospective analysis of the first 5 cases of robotic kidney transplantation with transvaginal insertion. Robotic-assisted kidney transplantation was performed after transvaginal insertion of a living donor kidney graft. Donor’s and recipient’s characteristics, intraoperative variables, postoperative complications, and surgical outcomes were assessed. Results: The median operative time was 220 min. Mean rewarming ischemia time of 53 min, with immediate diuresis. No intraoperative complications were observed. Mean hospitalization period was 9 days, with mean Cr of 1.5 mg/dL at discharge. Conclusions: Robotic kidney transplantation with transvaginal insertion is feasible and safe. A greater number of procedures are required to confirm the results of this new technique.

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