Computer-assisted robotic renal surgery

Abstract

Computer-assisted robotic renal surgery (CARRS) is a minimally invasive surgical treatment option for renal tumors. We review the literature regarding techniques and outcomes and the potential advantages of CARRS. We retrospectively reviewed the literature regarding techniques and outcomes of CARRS, with specific analysis on robotic radical nephrectomy (RRN) and robotic partial nephrectomy (RPN). Multiple papers on RRN and RPN were found where the techniques were performed with either a transperitoneal or a retroperitoneal approach. Preliminary outcomes with RRN and RPN were at least comparable to those of a laparoscopic approach, with some parameters of RPN improved over the laparoscopic approach (warm ischemia time, length of hospital stay and estimated blood loss). CARRS is an emerging field with preliminary outcomes at least comparable to the laparoscopic approach. Large prospective, randomized trials are needed to assess the benefit of CARRS compared with current methods.

Robotic-Assisted Renal Surgery

“…18 Other researchers have noted that case studies can be used as training for more technically challenging robotic-assisted NSS. 15,18 Despite the noted benefits, many series have compared LRN, HALRN, and RARN and found no significant difference in perioperative characteristics and have seen a trend toward increased operative time with RARN. 17,19,20 One study suggested that RARN is not cost effective.…”

“…The laparoscopic technique was introduced in the early 1990s and initial studies defined it as a viable and effective surgical technique. 15 Since then, a natural evolution has taken place over the last several years to incorporating robotic assistance. In 2005, Klingler et al 16 provided the initial report on the viability of robotic-assisted radical nephrectomy (RARN).…”

Kommentar zur Nephrektomie – laparoskopisch vs. robotisch

“…Weitere Studien zeigten auch bei der Tumornephrektomie die bekannten Vorteile des roboterassistierten Operierens wie das dreidimensionale vergrößerte stereoskopische Sehen, die Tremorelimination sowie die umfänglichen 7 Freiheitsgrade der Instrumentenbewegung. Der Einsatz eines vierten Roboterarms erleichtert die Retraktion der Niere nach kranial, die Exposition des Hilusbereichs unter Zug und damit eine beidhändige präzise Präpara-tion der Nierenstielgefäße [7].…”