Korean J Urol.  2008 May;49(5):387-391. 10.4111/kju.2008.49.5.387.

Robot-assisted Laparoscopic Partial Nephrectomy

• Park SY
• Kim HJ
• Seo JW
• Cho KS
• Ham WS
• Rha KH

• KMID: 1204517
• DOI: http://doi.org/10.4111/kju.2008.49.5.387

Abstract

PURPOSE: Laparoscopic partial nephrectomy is a treatment option for small renal masses. However, such time-consuming techniques such as tumor excision, hemostasis and intracoporeal suturing are still challenging procedures even for experienced laparoscopists. Incorporation of a robotic system would facilitate tumor excision, hemostasis and intracoporeal suturing. Herein, we review our technique and the short term outcomes for robot-assisted laparoscopic partial nephrectomy(RLPN).
MATERIALS AND METHODS
Eleven patients underwent RLPN for small renal masses. RLPN were performed with the da Vinci(R) robot system(Intuitive Surgical, Sunnyvale, USA) with three robot arms. In 7 cases, the renal hilum was clamped. Tumor excision and intracorporeal suturing were performed entirely with the robotic system. The specimen was extracted through the extended umbilical port incision.
RESULTS
The mean tumor diameter was 2.5+/-1.5cm. The mean operative time was 179.5+/-49.4 minutes and the mean estimated blood loss was 354.5+/-440.7ml. The mean warm ischemia time was 30.4+/-5.9 minutes for 7 patients. There were no major complications. The surgical pathology showed clear cell type renal cell carcinoma in 7, papillary type renal cell carcinoma in 1, angiomyolipoma in 2 and lipoma in 1. There were no positive surgical margins. The mean hospital stay was 4.2+/-1.3 days. No recurrence had been observed after 3 to 18 months of follow-up.
CONCLUSIONS
We were able to verify the feasibility and safety of using a RLPN in the management of small renal masses. Longer follow-up data and larger prospective studies are necessary to confirm these results.

Keyword

Robotics; Nephrectomy; Kidney neoplasms

Figure

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  Fig. 1. Port placement during robot-assisted laparoscopic left partial nephrectomy.

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  Fig. 2. Left renal mass excision with the robotic instruments.

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  Fig. 3. Suture closure, with using 2-0 VicrylⓇ, of the renal defect with using robotic instruments.

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