Trinity Health Kidney Transplant Center marks 50 years with upgraded surgical technology

GRAND RAPIDS — Trinity Health’s Kidney Transplant Center is celebrating its 50th anniversary with a new surgical technology that assists doctors while reducing risks for patients.

The Grand Rapids-based Transplant Center upgraded its da Vinci robots that allow doctors to perform robotic-assisted, live donor nephrectomies, or the surgical removal of a kidney.

Surgical Director Dr. Joel Stracke said the Kidney Transplant Center upgraded its da Vinci robots to the Xi model, the newest version that’s easier to maneuver and includes a smaller profile that can rotate around the patient in varying directions.

Dr. Joel Stracke
Dr. Joel Stracke, surgical director of Trinity Health’s Kidney Transplant Center. Credit: Trinity Health

“With a robotic procedure, we still make incisions into the abdomen, but instead of using just two hands, a surgeon has four robotic arms available at one time to also control the instruments and camera,” he said. “The nice thing about this approach is that we are able to make the large incision needed to remove the kidney much lower on the patient’s abdomen — under the pant line.”

Stracke said the robot allows surgeons to make a 3- to 4-inch horizontal abdominal incision known as a Pfannenstiel incision.

“With a Pfannenstiel incision, there is a little less pain, and a little less risk of hernia post-operatively for patients,” he said.

The robot also allows surgeons to see a 3-D representation of the operation site.

Prior to robotic assistance, Stracke said surgeons performed hand-assisted laparoscopic surgeries with incisions that were higher on the abdomen and ran vertically.

“When it is purely laparoscopic surgery, we are using basically straight tools that can go up and down and around in a circle in one access,” he said. “But with robotic surgery, it is still laparoscopic surgery by definition because we make those small, Band-Aid-size cuts, but instead of using straight laparoscopic instruments, we are using the arms of a robot.

“Now, of course, the robot is controlled by us — surgeons. This isn’t artificial intelligence. This is very much surgeon-directed surgery. We don’t just plug it in and say, ‘Hey, have at it, robot.’ We are in control of the robotic arms constantly. But the benefit of using the robotic arms is it isn’t just a straight tool anymore. It has a wrist like our hand so that instruments can go 360 degrees in every single direction.”

Trinity Health’s Kidney Transplant Center is the only kidney transplant center in West Michigan.

Stracke said the center has experienced an increase in the number of kidney transplants it has performed over the past four to five years. The Kidney Transplant Center performs about 100 kidney transplants each year.

In the United States, hypertension or high blood pressure as well as uncontrolled diabetes are the two most common reasons for kidney failure, Stracke said. Other contributing factors include autoimmune diseases that can affect the kidney, certain medications, and polycystic kidney disease, he added.

However, obtaining a kidney transplant can be difficult. Approximately 300 patients at Trinity Health’s Kidney Transplant Center are on a transplant waiting list, 155 of whom were added last year.

“There are lots of ways that we match a potential donor with a potential recipient,” Stracke said. “Once we know that the donor is going to be healthy before surgery and after surgery, we start working on matching, and matching comes in many different ways.”

Matching a donor with a recipient can be done primarily by matching blood types, he said.

“We also look at other small molecules on the blood cells to see what those matches are. There are a lot of different molecules on blood cells that we can use to hopefully increase the degree of match between a donor and a recipient,” Stracke said. “Our whole goal is to make that match as good as possible.”

The Kidney Transplant Center also attempts to increase matches through its partnership with the National Kidney Registry (NKR), a national organization that helps incompatible donors and recipients.

“If a friend wants to donate their kidney to a friend who has kidney failure, but they are not A, B, O compatible — and they can’t give directly to each other — we enter them into the NKR,” Stracke said. “And with the assistance of NKR, we are able to do national kidney swaps where the donor that we have will donate to another recipient, perhaps in another state.”