A Systematic Review of Clinical Outcomes in Laparoscopic versus Robotic Donor Nephrectomy
DOI:
https://doi.org/10.61194/ijss.v7i3.2344Keywords:
complications, hospital stay, laparoscopic donor nephrectomy, renal function, robotic donor nephrectomyAbstract
Living donor kidney transplantation remains the preferred treatment for end-stage renal disease because it provides superior long-term outcomes compared with dialysis. The increasing use of minimally invasive techniques, particularly Laparoscopic Donor Nephrectomy (LDN) and Robotic Donor Nephrectomy (RDN), has prompted comparisons of their perioperative performance and donor outcomes. This study systematically reviewed evidence comparing postoperative renal function, hospital length of stay, perioperative parameters, and postoperative complications between LDN and RDN. A systematic review following PRISMA guidelines searched PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar for comparative studies published between 2010 and 2025. Methodological quality was assessed using the Newcastle–Ottawa Scale and the JBI Critical Appraisal Checklist. Ten studies met the inclusion criteria and were synthesized qualitatively. The evidence indicates that RDN and LDN produce comparable postoperative renal function, including stable estimated glomerular filtration rate (eGFR) and serum creatinine levels. Several studies reported shorter hospital stays, lower early postoperative pain scores, and faster recovery with RDN, although robotic procedures required longer operative times during early implementation. Complication rates were generally low and similar between techniques. Overall, both LDN and RDN are feasible and safe minimally invasive approaches for living donor nephrectomy. However, variations in study design, institutional experience, and outcome reporting limit definitive conclusions regarding the superiority of either technique, highlighting the need for standardized high-quality comparative studies.
References
Bhattu, A. S., Ganpule, A., Sabnis, R. B., Murali, V., Mishra, S., & Desai, M. (2015). Robot-assisted laparoscopic donor nephrectomy vs standard laparoscopic donor nephrectomy: A prospective randomized comparative study. Journal of Endourology, 29(12), 1334–1340. https://doi.org/10.1089/end.2015.0213
Boyar, K., Pham, A., Swantek, S., Ward, G., & Herman, G. (2021). Laboratory Information Management Systems (LIMS). In Cannabis Laboratory Fundamentals (pp. 131–151). Springer International Publishing. https://doi.org/10.1007/978-3-030-62716-4_7
Calpin, G. G., Hehir, C., Davey, M. G., MacCurtain, B. M., Little, D., & Davis, N. F. (2025). Right and left living donor nephrectomy and operative approach: A systematic review and meta-analysis of donor and recipient outcomes. Transplantation Reviews, 39(1), 100880. https://doi.org/10.1016/j.trre.2024.100880
Centonze, A., Popolo, R., Panagou, C., Macbeth, A., & Dimaggio, G. (2023). Experiential techniques and therapeutic relationship in the treatment of narcissistic personality disorder: The case of Laura. Journal of Clinical Psychology, 79, 1656–1669. https://doi.org/10.1002/jclp.23514
Chan, L. W., Irish, G. L., Goh, T. L., Alnasrallah, B., Davies, C. E., Sypek, M. P., Clayton, P. A., & Collins, M. G. (2025). Outcomes of living kidney donors following donor nephrectomy in Aotearoa New Zealand. Kidney International Reports, 10(3), 762–771. https://doi.org/10.1016/j.ekir.2024.11.1362
Coco, D., & Leanza, V. (2025). Systematic review of robotic nephrectomy for kidney cancer. Journal of Kidney Cancer and VHL, 12(1), 29–35. https://doi.org/10.15586/jkc.v12i1.372
Dagnæs-Hansen, J., Kristensen, G. H., Rohrsted, M., Sørensen, S. S., & Røder, A. (2025). Early and Late Surgical Complications Following Living Donor Nephrectomy. Scandinavian Journal of Urology, 60, 83–89. https://doi.org/10.2340/sju.v60.43346
Dagnæs-Hansen, J., Kristensen, G. H., Stroomberg, H. V, Sørensen, S. S., & Røder, A. (2022). Surgical Approaches and Outcomes in Living Donor Nephrectomy: A Systematic Review and Meta-Analysis. European Urology Focus, 8(6), 1795–1801. https://doi.org/10.1016/j.euf.2022.03.021
Drukker, M., Weltens, I., van Hooijdonk, C. F. M., Vandenberk, E., & Bak, M. (2021). Development of a Methodological Quality Criteria List for Observational Studies: The Observational Study Quality Evaluation. Frontiers in Research Metrics and Analytics, 6, 675071. https://doi.org/10.3389/frma.2021.675071
Grigoriou, K., Karakasis, P., Nasoufidou, A., Stachteas, P., Klisic, A., Karagiannidis, E., Fyntanidou, B., Popovic, D. S., Patoulias, D., & Antoniadis, A. P. (2025). SGLT2 inhibitors in the management of cardio-renal-metabolic syndrome: A new therapeutic era. Medicina, 61(11), 1903. https://doi.org/10.3390/medicina61111903
Hinojosa-Gonzalez, D. E., Roblesgil-Medrano, A., Tellez-Giron, V. C., Torres-Martinez, M., Galindo-Garza, C. A., Estrada-Mendizabal, R. J., Alanis-Garza, C., Gonzalez-Bonilla, E. A., & Flores-Villalba, E. (2023). Robotic-assisted versus laparoscopic living donor nephrectomy for renal transplantation: A systematic review and meta-analysis. Annals of the Royal College of Surgeons of England, 105(1), 7–13. https://doi.org/10.1308/rcsann.2021.0357
Kędzierska-Kapuza, K., Łopuszyńska, I., Mizerska, A., Matejak-Górska, M., & Safranow, K. (2024). Robotic-Assisted Nephrectomy for Living Kidney Donation—Single Center Initial Experience (Case Series) and Review of the Literature. Journal of Clinical Medicine, 13(13), 3754. https://doi.org/10.3390/jcm13133754
Khajeh, E., Nikbakhsh, R., Ramouz, A., Majlesara, A., Golriz, M., Müller-Stich, B. P., Nickel, F., Morath, C., Zeier, M., & Mehrabi, A. (2023). Robot-assisted versus laparoscopic living donor nephrectomy: Superior outcomes after completion of the learning curve. Journal of Robotic Surgery, 17(6), 2513–2526. https://doi.org/10.1007/s11701-023-01681-0
Kourounis, G., Tingle, S. J., Hoather, T. J., Thompson, E. R., Rogers, A., Page, T., Sanni, A., Rix, D. A., Soomro, N. A., & Wilson, C. (2024). Robotic versus laparoscopic versus open nephrectomy for live kidney donors. Cochrane Database of Systematic Reviews, (5), CD006124. https://doi.org/10.1002/14651858.CD006124.pub3
Mamikutty, R., Aly, A. S., & Marhazlinda, J. (2021). Selecting Risk of Bias Tools for Observational Studies for a Systematic Review of Anthropometric Measurements and Dental Caries among Children. International Journal of Environmental Research and Public Health, 18(16), 8623. https://doi.org/10.3390/ijerph18168623
Matas, A. J., & Rule, A. D. (2022). Long-term medical outcomes of living kidney donors. Mayo Clinic Proceedings, 97(11), 2107–2122. https://doi.org/10.1016/j.mayocp.2022.06.013
Munoz Abraham, A. S., Morsi, M., & Vianna, R. (2025). Robotic assisted laparoscopic donor nephrectomy: An update. Current Urology Reports, 26(6), 35. https://doi.org/10.1007/s11934-025-01263-7
Musquera, M., Prudhomme, T., Ajami, T., Martínez, C., Carbonell, E., Munni, M., Leon, M., López de Mesa Rodriguez, B., Roca, I., Vilaseca, A., Ribal, M. J., Segura, N., Diekman, F., Revuelta, I., Tena, B., Monsalve, C., Peri, L., & Alcaraz, A. (2025). Living-donor kidney transplantation: Comparison of robotic-assisted versus conventional open technique. Transplant International, 38, 14953. https://doi.org/10.3389/ti.2025.14953
Napoli, N., Kauffmann, E. F., Ginesini, M., Gianfaldoni, C., Fiaschetti, P., Lombardi, I., Cardillo, M., Vistoli, F., & Boggi, U. (2024). Safety and safety protocols for living donor nephrectomy in Italy. Updates in Surgery, 76(1), 209–218. https://doi.org/10.1007/s13304-023-01678-2
Ortiz, F., Marson, L., Thomas, R., Kousios, A., Rista, E., Lefaucheur, C., Cimen, S., Cucchiari, D., Zaza, G., Furian, L., & Akin, B. (2025). Evaluating risk in kidney living donors. Transplant International, 38, 14024. https://doi.org/10.3389/ti.2025.14024
Pham, D. M., Truong, H. T. T., Le, H. T., Chuan, H. K., & Thai, M. S. (2026). Right robotic-assisted laparoscopic living donor nephrectomy: Initial results from a single-center retrospective study. Clinical Transplantation and Research. https://doi.org/10.4285/ctr.25.0064
Plage, H., Pielka, P., Liefeldt, L., Budde, K., Ebbing, J., Sugünes, N., Miller, K., Cash, H., Bichmann, A., Sattler, A., Kotsch, K., & Friedersdorff, F. (2020). Extended criteria donors in living kidney transplantation including donor age, smoking, hypertension and BMI. Therapeutics and Clinical Risk Management, 16, 1033–1044. https://doi.org/10.2147/TCRM.S267924
Serni, S., Pecoraro, A., Sessa, F., Gemma, L., Greco, I., Barzaghi, P., Grosso, A. A., Corti, F., Mormile, N., Spatafora, P., Caroassai, S., Berni, A., Gacci, M., Giancane, S., Tuccio, A., Sebastianelli, A., Li Marzi, V., Vignolini, G., & Campi, R. (2021). Robot-assisted laparoscopic living donor nephrectomy: The University of Florence technique. Frontiers in Surgery, 7, 588215. https://doi.org/10.3389/fsurg.2020.588215
Shen, C., Gu, D., Klein, R. W., Zhou, S., Shih, Y. C. T., Tracy, T. F., Soybel, D. I., & Dillon, P. W. (2020). Factors associated with hospital decisions to purchase robotic surgical systems. MDM Policy and Practice, 5(1). https://doi.org/10.1177/2381468320904364
Theodorakis, N., & Nikolaou, M. (2025). Integrated management of cardiovascular–renal–hepatic–metabolic syndrome: Expanding roles of SGLT2is, GLP-1 RAs, and GIP/GLP-1 RAs. Biomedicines, 13(1), 135. https://doi.org/10.3390/biomedicines13010135
Van de Geijn, E. F., Nijboer, W. N., Baranski, A. G., Huurman, V. A. L., Janki, S., de Vries, D. K., Alwayn, I. P. J., Nieuwenhuizen, J., Schaapherder, A. F. M., de Vries, A. P. J., & Lam, H. D. (2024). Effective and safe implementation of robot-assisted donor nephrectomy by experienced laparoscopic surgeons. World Journal of Surgery, 48(8). https://doi.org/10.1002/wjs.12249
Wang, L., Zhu, L., Xie, X., Wang, H., Yin, H., Fang, C., & Dai, H. (2020). Long-term outcomes of laparoscopic versus open donor nephrectomy for kidney transplantation: A meta-analysis. American Journal of Translational Research, 12(10), 5993–6002.
Windisch, O. L., Matter, M., Pascual, M., Sun, P., Benamran, D., Bühler, L., & Iselin, C. E. (2022). Robotic versus hand-assisted laparoscopic living donor nephrectomy: Comparison of two minimally invasive techniques in kidney transplantation. Journal of Robotic Surgery, 16(6), 1471–1481. https://doi.org/10.1007/s11701-022-01393-2
Xun, Y., Guo, Q., Ren, M., Liu, Y., Sun, Y., & Wu, S. (2023). Characteristics of the Sources, Evaluation, and Grading of the Certainty of Evidence in Systematic Reviews in Public Health: A Methodological Study. Frontiers in Public Health, 11, 998588. https://doi.org/10.3389/fpubh.2023.998588
Zaytoun, O., Elsawy, M., Ateba, K., Khalifa, A., Hamdy, A., & Mostafa, A. (2021). Laparoscopic donor nephrectomy: Technique and outcome, a single-center experience. African Journal of Urology, 27, 151. https://doi.org/10.1186/s12301-021-00254-7
Zeuschner, P., Hennig, L., Peters, R., Saar, M., Linxweiler, J., Siemer, S., Magheli, A., Kramer, J., Liefeldt, L., Budde, K., Schlomm, T., Stöckle, M., & Friedersdorff, F. (2020). Robot-assisted versus laparoscopic donor nephrectomy: A comparison of 250 cases. Journal of Clinical Medicine, 9(6), 1610. https://doi.org/10.3390/jcm9061610
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