Initial Clinical Experience with Robot-Assisted Laparoscopic Partial Nephrectomy for Complex Renal Tumors.
10.4111/kju.2009.50.9.865
- Author:
Kyung Hwa CHOI
1
;
Cheol Kyu OH
;
Wooju JEONG
;
Enrique Ian S LORENZO
;
Woong Kyu HAN
;
Koon Ho RHA
Author Information
1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. khrha@yuhs.ac
- Publication Type:Original Article
- Keywords:
Robotics;
Nephrectomy;
Kidney neoplasms
- MeSH:
Angiomyolipoma;
Arm;
Carcinoma, Renal Cell;
Humans;
Kidney Neoplasms;
Length of Stay;
Medical Records;
Nephrectomy;
Operative Time;
Robotics;
Warm Ischemia
- From:Korean Journal of Urology
2009;50(9):865-869
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Robot-assisted laparoscopic partial nephrectomy (RLPN) is gaining acceptance as an alternative to open partial nephrectomy and laparoscopic partial nephrectomy for small renal masses. However, it still remains a technically challenging procedure even for experienced laparoscopists. Endophytic tumors or renal hilar tumors pose an additional challenge. MATERIALS AND METHODS: We reviewed the medical records of 11 patients (mean age: 49.3 years; range: 31-67 years) who underwent RLPN for small, complex renal masses including hilar tumors and endophytic tumors. RLPN was performed with the Da Vinci(R) surgical system (Intuitive Surgical, Sunnyvale, USA) with three robot arms and intraoperative ultrasonography (Tile-pro(R) System). RESULTS: RLPN was performed successfully without complications in all cases. The mean tumor size was 3.2 cm (range, 1.1-8.0 cm). The mean operative time was 177 minutes (range, 150-260 minutes), and the mean warm ischemia time was 32 minutes (range, 25-41 minutes). The mean estimated blood loss was 177 ml (range, 50-350 ml), and the mean hospital stay was 4 days (range, 3-7 days). Pathology found four patients with clear cell type renal cell carcinoma, one with multilocular multicystic renal cell carcinoma, two with papillary type, one with chromophobe type, and three with angiomyolipoma. CONCLUSIONS: RLPN is a feasible and safe surgery for complex renal tumors. In our experiences, RLPN could be a nephron-sparing surgical option for patients with compromised renal function and it could be an alternative to open partial nephrectomy and laparoscopic partial nephrectomy for a select group of patients.
