Kidney transplantation is the best treatment option for patients with end-stage renal disease owing to improved survival and quality of life compared with dialysis. The surgical approach to kidney transplantation has been somewhat stagnant in the past 50 years, with the open approach being the only available option. In this scenario, evidence of reduced surgery-related morbidity after the introduction of robotics into several surgical fields has induced surgeons to consider robot-assisted kidney transplantation (RAKT) as an alternative approach to these fragile and immunocompromised patients. Since 2014, when the RAKT technique was standardized thanks to the pioneering collaboration between the Vattikuti Urology Institute and the Medanta hospital (Vattikuti Urology Institute-Medanta), several centres worldwide implemented RAKT programmes, providing interesting results regarding the safety and feasibility of this procedure. However, RAKT is still considered an alternative procedure to be offered mainly in the living donor setting, owing to various possible drawbacks such as prolonged rewarming time, demanding learning curve, and difficulties in carrying out this procedure in challenging scenarios (such as patients with obesity, severe atherosclerosis of the iliac vessels, deceased donor setting, or paediatric recipients). Nevertheless, the refinement of robotic platforms through the implementation of novel technologies as well as the encouraging results from multicentre collaborations under the umbrella of the European Association of Urology Robotic Urology Section are currently expanding the boundaries of RAKT, making this surgical procedure a real alternative to the open approach.

肾移植是终末期肾病患者的最佳治疗选择，因为与透析相比，肾移植可以提高生存率和生活质量。过去 50 年来，肾移植的手术方法一直停滞不前，开放手术是唯一可用的选择。在这种情况下，有证据表明，将机器人技术引入多个手术领域后，与手术相关的发病率有所降低，这促使外科医生考虑将机器人辅助肾移植（RAKT）作为治疗这些脆弱和免疫功能低下患者的替代方法。自 2014 年以来，由于 Vattikuti 泌尿外科研究所和 Medanta 医院 (Vattikuti Urology Institute-Medanta) 之间的开创性合作，RAKT 技术得到标准化，世界各地的多个中心实施了 RAKT 计划，提供了有关该手术的安全性和可行性的有趣结果。然而，RAKT 仍然被认为是主要在活体捐献者环境中提供的替代程序，因为它存在各种可能的缺点，例如复温时间长、学习曲线要​​求高以及在具有挑战性的情况下（例如肥胖患者）执行该程序的困难、严重的髂血管动脉粥样硬化、已故的供体环境或儿科受者）。尽管如此，通过实施新技术来完善机器人平台，以及在欧洲泌尿外科协会机器人泌尿科分会的支持下多中心合作取得的令人鼓舞的成果，目前正在扩大 RAKT 的范围，使这种外科手术成为真正的替代手术开放的方法。