My experience of a robotic assisted kidney transplant

Twenty years after being diagnosed with IgA nephropathy Martin Cook (below right) was advised to seek a live donor. His younger brother (below left) agreed to donate and Martin was offered the chance to have a robotic assisted transplant. Below he tells his story.

"In 1994 I was diagnosed with IgA nephropathy with a kidney function of 50%. My function gradually deteriorated over the next 20 years. In 2014 it started getting aggressive and my function deteriorated quickly. When I reached around 15/16% I was advised to seek a live donor. Thankfully my younger brother came forward and offered a kidney. Following a lengthy work up, we were eventually given a transplantation date of 1 September 2019.

I received a phone call from Guys Hospital asking if I would like to be considered for a robotic assisted transplant. Having heard of this procedure and how the recovery and scarring was much better than traditional surgery - I jumped at the offer!

I met with the professor who would be carrying out the procedure and he went through all the risks as well as the benefits and told me I would be only the ninth recipient to have a robot assisted transplant at Guys. I was still convinced that for me robotic assisted surgery was the best choice.

The transplant was expected to take approximately 5 hours, however the completed the operation successfully in just 3.5, proving they are getting more efficient at carrying out this procedure.

I came out of the theatre with a neck-line in place, three cannulas and a catheter. I had no drains or dressings in-situ. I was heavily dosed with painkillers so felt no pain at all, although I did have access to morphine via a control button should I need it but happily I didn't need to use it. My wife and son were there to support me, which really helped. My new kidney was working straight away from theatre and producing good results.

• Day 1: They gave me a chance to see my scarring (right). As the wounds were not dressed this was easy. The main scar where the kidney was inserted can be seen just above the waistline. The other smaller scars are where the robotic arms, saline, light, camera etc. were inserted. My stomach was distended due to the amount of air that was pumped into me, this went down within about a week.
• Day 2: As far as the transplant was concerned, I felt very little pain and had no need for any pain relief. However, I did have an issue with my bowels not waking up following the operation and took paracetamol for this. They removed one of the cannulas as well.
• Day 3: Saw further improvement, bowels were now working and I didn't require any pain relief. The two remaining cannulas and neckline were also removed - and still no painkillers required. I was now walking up and down the ward (carefully) and sitting in my chair, rather than having to lie on my bed during the day. My older brother came to visit and was pleasantly surprised at how well we both looked.
• Day 4: Catheter was removed - what a relief that was! I was feeling really good now and could feel my energy levels had risen. I was offered a chance to go home on this day, but opted for the next day due to transport arrangements. Dietician came to see me today to explain what I should avoid due to the drugs I'm now on.
• Day 5: Discharge day. Pharmacist came to see me to go through my new drug regime. Then it was time to say good-bye to Richard Bright ward and the wonderful staff that had given me fabulous care throughout and head home. My Gfr was 54% at this time.

My wife visited me in hospital every day, which gave me great encouragement and helped me recover. When I was at home my wife and son made sure I didn't do any lifting or overdo anything. The family introduced strict hygiene rules and all visitors to the house were told to wash hands and cover or remove their shoes as my immunosuppressant's dose was very high.

On my first day home (right) my mouth and throat began to feel very sore. It was so painful! I had developed ulcers in my mouth, later that week guys swabbed them and it was diagnosed as herpes virus. More tablets and a variation in some of my drug regime sorted it quickly."

Naturally following the transplant, I went home with a very long list of new medication to take. They are very time specific too, so ended up with four different alarms on my smart phone, to remind me. I also had to keep a daily log of BP, temperature, weight, fluids in and out. That week I had to attend clinic at Guys twice to check everything was going OK and that the blood results were good.

The second week they discharged me to Kent & Canterbury Hospital, as this was easier for me to get to from my home town of Gillingham. I attended clinic twice a week. At clinic they also checked my BP, temperature and checked bloods. I also saw a nurse or doctor on each visit. Seven weeks post transplant: The clinic have now reduced my clinic visits to once a week.

My scars are healing quickly. I was advised by the transplant surgeon to get a dog tag or wristband as the small scarring will almost disappear and the main scar will be hardly noticeable. So in the event of an emergency admission to hospital they will not be able to tell that I’ve had the transplant!