LAUSR

S ince its introduction, the minimally invasive, robotassisted approach has become an important alternative in kidney transplantation surgery. However, there is a concern about possible increases in warm ischemia time of the transplanted kidney. Recently, Meier et al described a novel intra-abdominal cooling system to address the lengthened ischemia time. In robot-assisted kidney transplantation in porcine models, they succeeded in suppressing the temperature elevation of the donated kidney during anastomosis with their cooling device. Similarly, we developed simple thermo-barrier bags (TBBs) which aim to suppress the temperature of the transplanted kidney in the intra-abdominal cavity. In a porcine kidney transplantation model, the TBB, which was designed to look like a purse, was effective in suppressing the temperature. The temperature of the porcine model with a TBB was 20°C with an operative time of 30 minutes, whereas the temperature of a porcine model without a TBB rose as high as 30°C. Meier et al reported that their novel cooling device kept the temperature of the recovered kidney at 4°C to 6°C for 70 minutes during vascular anastomosis until reperfusion. On the other hand, the temperature of the porcine model without a cooling device elevated as