Robot-assisted laparoscopic partial nephrectomy is a safe and effective option for clinical T2 renal cell carcinoma: a case-series from single-institution

Long, Gongwei; Liu, Man; Zhang, Yucong; Sun, Guoliang; Ouyang, Wei; Yang, Jun; Wang, Zhihua; Liu, Zheng; Guan, Wei; Hu, Zhiquan; Wang, Shaogang; Li, Heng

doi:10.21037/tcr-20-2324

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…The incidental detection of renal masses is increasing according to more frequent utilization of ultrasonography, computed tomography (CT) and other imaging techniques ( 10 ). Laparoscopic partial nephrectomy (LPN) is the current standard of treatment for renal carcinoma, especially in patients with tumors <4 cm ( 1 , 2 , 11 , 12 ), we perform laparoscopic radical nephrectomy when there is no possibility for preserving the kidney. Laparoscopic renal surgery can be performed either transperitoneally (TP) or retroperitoneally (RP).…”

Section: Discussionmentioning

confidence: 99%

Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

Alimu¹,

Dai²,

Huang³

et al. 2022

Transl Cancer Res TCR

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Background As the development of various imaging techniques, the incidental detection of renal masses is increasing. Laparoscopic partial nephrectomy (LPN) is the current standard of treatment for renal carcinoma. Though the retroperitoneal laparoscopic partial nephrectomy (RLPN) become the prior choice, the edge of lateroconal fascia blocks the sight and make operation more challenging. Methods Between October 2018 and December 2020, the clinical data of 28 cases diagnosed with renal cell carcinoma (RCC) in our hospital was collected and analyzed retrospectively. All patients underwent RLPN and for management of curtain effect, we performed lateroconal fascia suspension (LFS) procedure in all cases with prepared Hem-o-lock clip which bound with 2-0 suture. Results RLPN for renal tumor was successfully performed in all cases with no conversions to open surgery and other interruptions. In all cases, the free edge of lateroconal fascia and peritoneum partially blocked the sight of surgeon. We managed the curtain effect successfully and got a satisfying field of view for subsequent surgical procedure. The median operation time was 142 [interquartile range (IQR), 110–164] min, median estimated blood loss was 93 (IQR, 50–100) mL. Median warm ischemia time was 29 (IQR, 22–30) min. Conclusions LFS is useful for management of curtain effect. It is a simple, economical and less invasive technique and we can get better efficiency with little consumption.

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Section: Discussionmentioning

confidence: 99%

Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

Alimu¹,

Dai²,

Huang³

et al. 2022

Transl Cancer Res TCR

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“…1 ). Long et al [ 8 ] reported that RAPN showed good preservation of renal function and acceptable perioperative and oncologic outcomes in treating large renal tumors (>7 cm), suggesting that RAPN is a safe and effective procedure (WIT of 20.0 min, no patients died, and no local recurrence during a mean follow-up of 31.0 months). In a multicenter analysis conducted by 19 robotic centers, Bertolo et al [ 9 ] reported that RAPN showed acceptable outcomes in the treatment of large renal masses above T2 and that it was safely performed (WIT of 25 min, positive surgical margins [PSMs] in 20 patients [8%], 10 deaths and 25 recurrences/metastases during a follow-up period of 12 months).…”

Section: Large and Complex Renal Tumor In Rapnmentioning

confidence: 99%

How far has robot-assisted partial nephrectomy reached?

Lee,

Alabbasi,

Chung

et al. 2023

Investig Clin Urol

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Nephron-sparing surgery is the standard treatment for small renal mass (SRM). Nephron-sparing surgery has evolved from an open to a minimally invasive technique. Robot-assisted partial nephrectomy (RAPN) is the latest technique in this field and is reported to be safe and feasible, showing oncologically and functionally superior or compatible results compared with open and laparoscopic partial nephrectomy for SRM. This is not limited to only SRM but also applies to large and complex renal masses and other challenging situations. RAPN showed good oncological and functional outcomes for ≥clinical T2 renal tumors, complex renal masses (PADUA score ≥10, RENAL score ≥10), hilar renal tumors, and multiple renal tumors. In addition, the outcomes of RAPN in these challenging cases were not inferior to those in conventional cases. RAPN could also be applied to a number of challenging cases in which the open technique was considered first. RAPN showed good results in patients with a solitary kidney, horseshoe kidney, and in repeat surgeries. Furthermore, RAPN could be safely performed on obese, elderly, and pediatric patients. Finally, this review evaluates efficiency and utility of RAPN based on the results of challenging cases of renal masses and to project the future of RAPN.

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“…Technological advances have fueled a paradigm shift from open surgery to minimally invasive techniques for PN (2). Indeed, minimally invasive approaches, including laparoscopic PN and more recently, robot-assisted (RA) procedures, have been increasingly accepted as a reliable surgical option for patients with small renal tumors, largely due to the refinement of surgical techniques and instruments (3,4).Compared with open nephron-sparing surgery (NSS), robot-assisted partial nephrectomy (RAPN) has achieved good results with accurate resection of tumors, protection of renal function, and prevention and control of perioperative complications (5)(6)(7). These advantages have resulted in a surge of robotic surgeries in hospitals.…”

Section: Introductionmentioning

confidence: 99%

Holographic reconstruction technology used for intraoperative real-time navigation in robot-assisted partial nephrectomy in patients with renal tumors: a single center study

Zeng¹,

Zhou²,

Wang³

et al. 2021

Transl Androl Urol

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Background: To explore the efficacy and advantages of real-time navigation using holographic reconstruction (HR) technology combined with da VinciTM robotic system for partial nephrectomy (PN) in patients with renal tumor. Methods:The clinical data of 41 patients with totally intrarenal tumors receiving robot-assisted partial nephrectomy (RAPN) from April 2018 to October 2020 in our department were collected and retrospectively analyzed. All operations were performed by the same surgeon. HR technology and three-dimensional (3D) reconstruction techniques were applied for real-time navigation to resect tumors using the da VinciTM robotic system. The relevant clinical parameters and surgical outcomes of the patients were recorded and analyzed.Results: HR technology allowed accurate evaluation of tumors, renal hilus vessels, and surrounding organs during the operation. With real-time navigation HR, all cases were performed by RAPN. The mean operative time was 115.3±20.3 (range, 70-153) minutes, and the warm ischemia time (WIT) was 18.7±3.9 (range, 13-28) minutes. The estimated blood loss (EBL) was 98.8±18.7 (range, 60-141) mL.Negative surgical margins were reported in all cases. Patients with absence of grade ≤1 Clavien-Dindo complications. Compared with the clinical outcomes of standard RAPN, as reported in the literature, HRassisted technology reduced the mean operative time, the WIT, and the EBL in patients undergoing RAPN. Therefore, combining HR with robotic abdominal surgery can enhance the efficiency of locating blood vessels and allow for more accurate resection of tumors.Conclusions: As a novel and promising computer digital technology, HR can significantly improve the success of RAPN operations. This retrospective study demonstrated that HR-assisted operations resulted in shorter operation times and less perioperative complications and were thus safer and more effective in patients with renal tumors compared with RAPN not used HR.

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Robot-assisted laparoscopic partial nephrectomy is a safe and effective option for clinical T2 renal cell carcinoma: a case-series from single-institution

Cited by 6 publications

References 36 publications

Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

How far has robot-assisted partial nephrectomy reached?

Holographic reconstruction technology used for intraoperative real-time navigation in robot-assisted partial nephrectomy in patients with renal tumors: a single center study

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