Robot-assisted partial nephrectomy in contemporary practice

Abstract

Laparoscopic renal surgery is associated with reduced blood loss, shorter hospital stay, enhanced cosmesis, and more rapid convalescence relative to open renal surgery. Laparoscopic partial nephrectomy (LPN) is a minimally invasive, nephron-sparing alternative to laparoscopic radical nephrectomy (RN) for the management of small renal masses. While offering similar oncological outcomes to laparoscopic RN, the technical challenges and prolonged learning curve associated with LPN limit its wider dissemination. Robot-assisted partial nephrectomy (RAPN), although still an evolving procedure with no long-term data, has emerged as a viable alternative to LPN, with favorable preliminary outcomes. This article provides an overview of the role of RAPN in the management of renal cell carcinoma. The clinical indications and principles of surgical technique for this procedure are discussed. The oncological, renal functional, and perioperative outcomes of RAPN are also evaluated, as are complication rates.

Console-integrated real-time three-dimensional image overlay navigation for robot-assisted partial nephrectomy with selective arterial clamping: early single-centre experience with 17 cases

“…Despite our early series consisting of the initial 17 cases, the preliminary clinical outcomes of this study seem to be promising. There was no patient requiring conversion from selective to main artery clamping, and major perioperative parameters, including the warm ischaemia time, estimated blood loss, positive surgical margin and complications in this series, were comparable or even superior to those in previous studies evaluating conventional RAPN (15,24). Taken together, these findings suggest that our segmental clamping technique could be completed irrespective of patient characteristics.…”

Electrocoagulation with greased lidocaine gel 2% as hemostatic maneuver after minimally invasive partial nephrectomy: Experimental and preliminary clinical results

“…During conventional renal resection, despite the control of the renal hilum for partial resection, bleeding still occurs. Several surgeons use total or selective vascular clamping maneuvers in attempt to decrease blood loss [10]. However, this manouver is accompanied by temporary organ ischemia, which can be deleterious when longer than 30 minutes [8].…”