Robot-assisted Renal Auto Transplantation: State of the Art.

Robot-assisted renal auto transplantation (RAKAT) has emerged as a minimally invasive alternative to open kidney autotransplantation (KAT) for the treatment of complex renovascular and ureteral conditions. The overall quality of evidence remains low, as most studies are characterized by small sample sizes, heterogeneous indications, and variability in surgical technique and outcome reporting. These limitations make direct comparisons difficult and currently preclude the feasibility of randomized controlled trials. However, these studies represent the current evidence on the topic. Moreover, intracorporeal RAKAT approaches may reduce ischemia time in selected patients but are technically demanding, whereas extracorporeal RAKAT techniques facilitate complex vascular reconstruction and standardized graft preparation. Available comparative data suggest that both approaches are safe and feasible, with differences primarily related to ischemia times and early postoperative renal function recovery, whereas long-term outcomes and complication rates appear broadly comparable. Overall, RAKAT represents a promising evolution in KAT, bridging the advantages of minimally invasive surgery.