Jan. 20, 2026
Transplant surgeons across Mayo Clinic are increasingly turning to robot-assisted kidney transplantation as an option for patient care. As experience with the robotic platform grows, teams continue to refine surgical techniques and improve processes for identifying patients who are best suited for this approach.
Advantages of robotic kidney transplant
Robot-assisted kidney transplantation has several unique distinctions compared with traditional open surgery. In the robotic procedure, the surgeon does not stand directly over the surgical field and place hands inside the patient. Instead, the surgeon sits at a console and controls robotic instruments introduced through small incisions, similar to laparoscopic surgery.
Importantly, the robot does not make any movements on its own — every action originates from the surgeon's hand movements at the console. Surgical assistants continue to maintain direct contact with the patient and manage instrument exchanges at the bedside.
For patients, a robot-assisted kidney transplant offers these benefits:
- Smaller incisions. The surgeon creates an approximately 2-inch incision around the belly button, as well as smaller incisions for robotic ports. In traditional open kidney transplantation, the incision may span 4 to 10 inches.
- Lower incision option for cosmetic purposes. With robotic surgery, the incision can be positioned lower on the abdomen than in traditional open surgery, offering a cosmetic advantage for some patients.
- Lower complication risk. Smaller incisions reduce the risk of complications such as hernia and infection.
- Faster recovery. Reduced tissue disruption typically leads to shorter healing time and earlier return to work or daily activities.
- Less discomfort and shorter hospitalization. Smaller incisions often translate to less pain and earlier discharge compared with open surgery.
For surgeons, a robot-assisted transplant offers these benefits:
- Reduced physical strain. Instead of standing for hours at the operating table, the surgeon sits at the console. Evidence suggests that prolonged standing may contribute to occupational health risks, according to findings published in the journal Rehabilitation Nursing. The robotic platform may reduce this strain.
- Enhanced visualization. The robotic system provides a magnified, high-definition view of the operative field, improving precision.
A matter of patient preference
Kidney transplantation remains the best treatment for patients with kidney failure. Mayo Clinic performs nearly 1,000 kidney transplants each year across all sites. While most are still performed through an open approach, robot-assisted kidney transplantation is becoming more common.
Eligibility for robot-assisted kidney transplant may be limited by factors such as serious heart disease, severe vessel disease, prior kidney transplant or multiple surgeries in the abdomen, and polycystic kidney disease associated with severe enlargement of the native kidneys. Because patients with kidney failure often have complex medical histories — including diabetes and or other chronic conditions — decisions are often made in consultation with other specialties, such as cardiology and endocrinology.
"We try to promote a shared decision-making model, especially when we're implementing newer tools," said Ty S. Diwan, M.D., an abdominal transplant surgeon at Mayo Clinic in Rochester, Minnesota, and a member of the surgical team that performed Minnesota's first robot-assisted kidney transplant. "This isn't a traditional approach, so we need to make sure we have a thorough discussion, and patients understand everything and are comfortable."
Dr. Diwan adds that he and his surgical team discuss procedural differences with eligible patients. For example, using the robotic platform may add about an hour to the procedure during the early learning phase, as surgeons gain experience with the technology. As proficiency increases, operative times typically decrease, and the approach is commonly associated with faster and smoother recovery.
An emphasis on patient outcomes
Although only a limited number of programs nationwide offer robotic kidney transplantation, Mayo Clinic's kidney transplant team members focus on quality, not quantity.
"In patients who meet criteria to receive robotic kidney transplant, the goal is to provide improved outcomes. So, smaller incisions, less pain, quicker recovery, and faster return to work or to their day-to-day life," says abdominal transplant surgeon Michelle C. Nguyen, M.D., who led the team that performed this procedure at Mayo Clinic in Arizona for the first time.
Robot-assisted kidney transplant is unlikely to replace open kidney transplantation entirely. Given its long record of safety and success, traditional open transplant will remain the preferred option for most patients. However, use of robotic kidney transplantation is steadily increasing, particularly for selected patients who may benefit from minimally invasive advantages as surgical teams gain experience and technology continues to evolve.
For more information
Waters TR, et al. Evidence of health risks associated with prolonged standing at work and intervention effectiveness. Rehabilitation Nursing. 2015;40:148.
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