Learning curve of robotic living donor Nephrectomy: Results from a high-volume transplantation center

Laparoscopic living donor nephrectomy (LDN) has been the standard procedure for kidney harvesting across numerous institutions globally. The utilization of the robotic system provides superior attributes that facilitate the surgical process and diminish the learning curve. We have conducted an analysis of the learning curve associated with the robotic donor nephrectomy (RDN) for harvesting the left kidney at our center. An analysis was conducted on consecutive cases of RDN performed by the same surgical team. To mitigate confounding factors, we analyzed the cases involving simple renal vascular structures, specifically those consisting of a single artery and a single vein. The study was carried out at Cho Ray Hospital from May 2018–02/2025. Demographic characteristics and surgical outcomes were recorded. A total of 30 donors with uncomplicated renal vascular structures who underwent left RDN were analyzed. Mean age was 47.6 ± 8.6 years, and mean BMI was 23.1 ± 2.4 kg/m 2 . Mean operative time was 201.3 ± 48.6 min, with an estimated blood loss of 68.7 ± 44.9 mL. Mean warm ischemic time was 5.0 ± 1.2 min. Neither intraoperative complications nor open conversions were observed. Analysis of the learning curve indicated that operative time significantly improved after the initial 15 cases, from 220 to 182 min (Δt = −38 min, p = 0.033). Robotic donor nephrectomy for transplantation is a promising method with high safety and efficacy, and a rapid learning curve. Consequently, this methodology shows substantial potential for extensive application in kidney harvesting for transplantation purposes.