Technique and Outcomes of Robot-assisted Retroperitoneoscopic Partial Nephrectomy: A Multicenter Study

Hu, Jim C.; Treat, Eric; Filson, Christopher P.; McLaren, Ian D.; Xiong, Shangkun; Stepanian, Sevan; Hafez, Khaled S.; Weizer, Alon Z.; Porter, James

doi:10.1016/j.eururo.2014.04.028

Cited by 73 publications

(48 citation statements)

References 40 publications

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“…20 WIT has also been found to inversely correlate with surgeon volume, across multiple surgeons and institutions. 21 TPRPN is a more familiar modality for many surgeons 12 and is the preferred approach for anterior tumors. 1,[6][7][8] In several studies examining the impact of tumor location on surgical approach, it was found that anterior tumors were treated more often with the TP approach with rates of 62%-97%, 1,6-8 but even posterior tumors were treated transperitoneally in 17%-30%.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Transperitoneal Approach to Robot-Assisted Laparoscopic Partial Nephrectomy for the Treatment of Anterior and Posterior Renal Masses

Paulucci

Whalen

Badani

2015

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Section: Discussionmentioning

confidence: 99%

Analysis of the Transperitoneal Approach to Robot-Assisted Laparoscopic Partial Nephrectomy for the Treatment of Anterior and Posterior Renal Masses

Paulucci

Whalen

Badani

2015

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Our recent description of robotic retroperitoneal partial nephrectomy, which permits direct access to renal hilum for posterior renal and hilar tumors is an effort in this direction [59]. A multi-centric study by Hu et al [60] showed retroperitoneal RAPN to have acceptable morbidity and cancer control outcomes over a median follow-up of 2.7 years, proving retroperitoneal RAPN to be a reasonable option for patients with posterior renal masses or with prior abdominal surgery.…”

Section: Robotic Upper Tract and Renal Surgerymentioning

confidence: 97%

WITHDRAWN: The growth of computer-assisted (robotic) surgery in urology 2000–2014: The role of Asian surgeons

Dalela¹,

Ahlawat²,

Sood³

et al. 2014

Asian Journal of Urology

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Objective: A major role in the establishment of computer-assisted robotic surgery (CARS) can be traced to the work of Mani Menon at Vattikuti Urology Institute (VUI), and of many surgeons of Asian origin. The success of robotic surgery in urology has spurred its acceptance in other surgical disciplines, improving patient comfort and disease outcomes and helping the industrial growth. The present paper gives an overview of the progress and development of robotic surgery, especially in the field of Urology; and to underscore some of the seminal work done by the VUI and Asian surgeons in the development of robotic surgery in urology in the US and around the world. Methods: PubMed/Medline and Scopus databases were searched for publications from 2000 through June 2014, using algorithms based on keywords "robotic surgery", "prostate", "kidney", "adrenal", "bladder", "reconstruction", and "kidney transplant". Inclusion criteria used were published full articles, book chapters, clinical trials, prospective and retrospective series, and systematic reviews/meta-analyses written in English language. Studies from Asian institutions or with the first/senior author of Asian origin were included for discussion, and focused on techniques of robotic surgery, relevant patient outcomes and associated demographic trends. Results: A total of 58 articles selected for final review highlight the important strides made by robots in urology, from robotic radical prostatectomy in 2000 to robotic kidney transplant in 2014. In the hands of an experienced robotic surgeon, it has been demonstrated to improve functional patient outcomes and minimize perioperative complications compared to open surgery, especially in urologic oncology and reconstructive urology. With increasing surgeon proficiency, the benefits of robotic surgery were consistently seen across different surgical disciplines, patient populations, and strata. (D. Dalela). Peer review under responsibility of Chinese Urological Association and SMMU. + MODEL Please cite this article in press as: Dalela D, et al., The growth of computer-assisted (robotic) surgery in urology 2000e2014: The role of Asian surgeons, Asian Journal of Urology (2015), http://dx.

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“…If pneumopressure is reduced, venous hemorrhage substantially increases and the operative field will be broken. Especially with the retroperitoneal approach, the working space and consisting air volume is very limited . When the surgical site assistant evacuates considerable air volume, the settled field and vision will be easily diminished.…”

Section: Technical Advancementsmentioning

confidence: 99%

Robot‐assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy

et al. 2015

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Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robotassisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm 2 , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy will be more frequently carried out as a safe, effective and minimally-invasive nephronsparing surgery procedure.

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Technique and Outcomes of Robot-assisted Retroperitoneoscopic Partial Nephrectomy: A Multicenter Study

Cited by 73 publications

References 40 publications

Analysis of the Transperitoneal Approach to Robot-Assisted Laparoscopic Partial Nephrectomy for the Treatment of Anterior and Posterior Renal Masses

Analysis of the Transperitoneal Approach to Robot-Assisted Laparoscopic Partial Nephrectomy for the Treatment of Anterior and Posterior Renal Masses

WITHDRAWN: The growth of computer-assisted (robotic) surgery in urology 2000–2014: The role of Asian surgeons

Robot‐assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy

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