AirSeal Ò trocar were placed. Fireflyä Fluorescence was used to verify adequate vascular supply of resected ureter. AR-3D video stream was then used for the exact identification and dissection of renal hilum: the 3D virtual model was manually oriented through the AR-dedicated workstation by the assistant engineer. The overlapped 3D images of the renal model allowed the surgeon to identify the precise anatomy of the renal hilum early and safely. Intuitive endowrist stapler 30 Ò was then used to seal and cut renal artery. Graft harvest was achieved with Applied Inzii Retrieval System Ò through GelPort Ò System to assure rapid graft retrieval minimizing ischemia time. RESULTS: Overall operative time was 270min. Console time was 178min. Time from renal artery division to graft harvest was 2min 56sec. Overall ischemia time was 140min (including harvest, back-table and transplant). Patient was discharged 4 days after surgery. Neither early nor late complications were reported; renal function at time of discharge was within normal range. Graft transplantation was successful. CONCLUSIONS: The use of AR during RALDN may improve the understanding of renal anatomy thus facilitating the management of the hilum and enhancing the safety and the chances of a successful kidney transplant. Source of Funding: None V02-04 ROBOT-ASSISTED MANAGEMENT OF URETERAL COMPLICATIONS IN KIDNEY TRANSPLANT PATIENTS: CASE SERIES AND DESCRIPTION OF SURGICAL TECHNIQUES Joris Vangeneugden, Charles Van Praet*, Liesbeth Desender, Caren Randon, Steven Van Laecke, Patrick Peeters, Evi Nagler, Jill Vanmassenhove, Karel Decaestecker, Gent, Belgium INTRODUCTION AND OBJECTIVE: Ureteral complications following renal transplant procedures are common and mainly include urinary leaks, ureteral stenosis, vesicoureteral reflux (VUR) and acute graft pyelonephritis. First approaches for the management of stricture and VUR include, respectively, percutaneous balloon dilation with or without laser incision and endoscopic injection of dextranomer/hyal- uronic acid copolymer. In case of recurrence after a primary endouro- logical approach, a stricture >1cm or complex anatomy in transplant patients, ureteral reimplantation should be performed. A robotic approach may reduce morbidity in a fragile transplant population. We describe our case series and surgical video of robot-assisted ureteral reimplantation in kidney transplant patients. METHODS: We present 20 renal transplant patients who suf- fered from ureteral complications: 15 with VUR and 5 with ureteral stenosis. Given the complex anatomy and/or failed first endoscopic treatments, ureteral reimplantation was indicated in all cases. As each case had a unique indication and anatomy, five different surgical ap- proaches were used, as displayed in the video: Lich-Gregoir non- dismembered and dismembered, uretero-ureterostomy, and ipsilateral and contralateral pyelo-ureterostomy. All surgeries were performed using the Da Vinci XiÒ robot. RESULTS: All surgeries were completed successfully without intraoperative complications. Median pre- and postoperative (3 months) GFR values were 53 ml/min (IQR 30-70) and 55 ml/min (IQR 43-66) respectively in patients who suffered from VUR and 29 ml/min (IQR 22- 36) and 35 ml/min (IQR 29-49) in patients who suffered from stenosis. Median hospital stay was 3 days (IQR 2-4). One patient had post- operative laryngeal edema requiring intensive care admission (Clavien- Dindo grade 4), one patient needed repositioning of a dislocated JJ stent (grade 3b), one patient had erysipelas of the left arm and one patient had febrile urinary tract infection within 90 days requiring anti- biotics (both grade 2). No other complications occurred and all patients were free from nephrostomy tube or double J stent at a median follow- up of 12 months (IQR 7-19). CONCLUSIONS: We demonstrate the safety, feasibility and surgical technique of robot-assisted ureteral reimplantation options in kidney transplant patients. This approach allows for high-quality realignment of the urinary tract, a quick recovery with low complication rate and preserved renal function in a fragile renal transplant population. Source of Funding: None V02-05 INTRACORPOREAL AND EXTRACORPOREAL ROBOT-ASSISTED KIDNEY AUTO-TRANSPLANTATION: EXPERIENCE OF THE ERUS RAKT WORKING GROUP Alberto Breda, Pietro Diana, Irene Giron-Nanne, Angelo Territo*, Andrea Gallioli, Alberto Piana, Josep Maria Gaya, Barcelona, Spain; Liesbeth Desender, Benjamin Van Parys, Charles Van Praet, Ghent, Belgium; Joan Palou, Barcelona, Spain; Nicolas Doumenec, Toulouse, France; Karel Decaestecker, Ghent, Belgium INTRODUCTION AND OBJECTIVE: Kidney auto- transplantation is a useful technique to be reserved for cases where kidney function is compromised by a complex anatomical configuration, such as long ureteric strictures and renal vascular anomalies not suitable for in situ reconstruction. Robotic-assisted kidney auto-transplantation (RAKAT) presents a novel, minimally invasive and highly accurate approach. METHODS: We retrospectively analyzed patients undergoing standard (eRAKAT) and totally intracorporeal RAKAT (iRAKAT) in a total of 3 institutions. eRAKAT consisted in a bench surgery for graft preparation after the robotic nephrectomy and was followed by graft transplantation. iRAKAT consisted in a nephrectomy phase followed by intracorporeal reperfusion and transplantation. RESULTS: Between 01/2017 and 02/2021, 29 patients under- went RAKAT. 15 and 14 were eRAKAT and iRAKAT, respectively. Median age was 42 (39-50.5) and 37.5 (25.8-55.4) for the eRAKAT and iRAKAT, respectively. In the eRAKAT and iRAKAT groups, 10, 4 and 1 patients and 10, 4, and 0 patients presented with 1, 2 and 3 arteries, respectively and 13 and 2 patients and 14 and 0 patients presented with 1 and 2 veins, respectively. Pre-op median serum creatinine and GFR were for the eRAKAT group 0.79 mg/dL (0.71-0.86) and 90 (78.4-109.1) and for the iRAKAT group 0.83 (0.76-1.05) and 84 (67-99), respectively. None required conversion to open surgery. For the standard group, median operative time was 360 min (339-397). eRAKAT median warm ischemia, cold ischemia and rewarming ischemia times were 3 (2-4), 156 (131-194), 44 (43-49.5) min respectively. For the iRAKAT group, median operative time was 307 min (292.5-467.7). Median warm ischemia, cold ischemia and rewarming ischemia times were 3 (2.8-3), 27.5 (20-55.1), 46.5 (24.2-58.2) min respectively. 3 patients developed classified as Clavien-Dindo >2 in the eRAKAT group and 1 patient for the iRAKAT, none led to graft loss. At 90 days follow-up, serum creatinine and GFR were 0.78 (0.71-0.82) and 85.5 (81.7- 109.4), and 0.91 (0.8-1.1) and 81 (69-87.5) for the eRAKAT and iRAKAT group respectively. CONCLUSIONS: eRAKAT and iRAKAT represents a promising minimally-invasive technique in selected cases with acceptable ischemia time and operative outcomes. The eRAKAT technique leads to the advantages of a better graft vascular management and reconstruction. The iRAKAT technique despite the higher technical difficulty, leads to shorter cold ischemia times. Comparative studies are needed to characterize and define the indications for the two approaches. Source of Funding: None V02-06 ROBOTIC-ASSISTED TESTICULAR AUTOTRANSPLANTATION Brian Chao*, Nabeel Shakir, Jamie Levine, Lee Zhao, New York, NY INTRODUCTION AND OBJECTIVE: Silber and Kelly first described the successful autotransplantation of an intra-abdominal e134 THE JOURNAL OF UROLOGY Ò Vol. 206, No. 3S, Supplement, Friday, September 10, 2021 Copyright © 2021 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.