Strategies in the management of renal tumors amenable to partial nephrectomy

Abstract

In our institution, the hand-assist approach to laparoscopic partial nephrectomy has resulted in favorable perioperative outcomes. The use of an in-room pathologist to provide real-time assessment of gross tumor margins has allowed us to achieve a 0% positive final margin rate. We believe that the use of an in-room pathologist during the timely extraction of the specimen made possible by the hand-assisted approach provides a great advantage over pure laparoscopic partial nephrectomy. This low positive margin rate is also the result of maintaining a bloodless field of resection with temporary renal arterial occlusion as well as the avoidance of visual tissue distortion with cold, sharp scissor dissection.

Radiofrequency Ablation–Assisted Robotic Laparoscopic Partial Nephrectomy Without Renal Hilar Vessel Clamping Versus Laparoscopic Partial Nephrectomy: A Comparison of Perioperative Outcomes

“…9 This is reflected in the underutilization of partial nephrectomy as treatment of renal masses. 9,10 Minimally invasive techniques attempting to decrease the difficulty and morbidity of nephron-sparing surgery have been developed, including hand-assisted LPN, 11,12 cryoablation, 13,14 and radiofrequency ablation (RFA). 15 RFA-assisted LPN was developed to overcome the challenges of LPN.…”