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Single Port Robotic Nephrectomy via lower anterior retroperitoneal approach: feasible, safe and effective option in surgically complex patients.
Orsini, Angelo; Lasorsa, Francesco; Bignante, Gabriele; Yoon, Jamie; Dymanus, Kyle Anna; Cherullo, Edward E; Autorino, Riccardo.
Afiliação
  • Orsini A; Department of Urology, Rush University, Chicago, IL, USA.
  • Lasorsa F; Department of Urology, D'Annunzio University of Chieti-Pescara, Chieti, Italy.
  • Bignante G; Department of Urology, Rush University, Chicago, IL, USA.
  • Yoon J; Division of Urology, Department of Precision and Regenerative Medicine and Ionian Area-Urology, Andrology and Kidney Transplantation Unit, University of Bari "Aldo Moro", Bari, Italy.
  • Dymanus KA; Department of Urology, Rush University, Chicago, IL, USA.
  • Cherullo EE; Division of Urology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy.
  • Autorino R; Department of Urology, Rush University, Chicago, IL, USA.
Int Braz J Urol ; 50(6): 785-786, 2024.
Article em En | MEDLINE | ID: mdl-39133791
ABSTRACT

PURPOSE:

Minimally invasive radical nephrectomy is often preferred for larger renal tumours not suitable for partial nephrectomy (1). When performed with a multiport robot, the procedure is routinely performed with a transperitoneal approach, with recent studies highlighting important factors for surgical outcomes, including predictive factors (2), segmental artery unclamping techniques (3), and comparisons of robotic techniques (4). This video shows that SP Robot-Assisted Radical Nephrectomy (RARN) via a lower anterior approach is valuable in challenging cases. MATERIALS AND

METHODS:

We performed SP-RARN on two complex patients using a retroperitoneal lower anterior approach. The first patient, a 54-year-old female with a BMI of 36.8 kg/m², had a ventral hernia and bowel obstruction history, with a 9 cm right middle kidney mass. The second patient, a 58-year-old male with a BMI of 31.19 kg/m², had ESRD and was on peritoneal dialysis for 8 years, with a 3.4x3.7 cm mass in the right superior pole, suspected to be RCC. The surgical technique is detailed in the video.

RESULTS:

Both procedures were successful, with operative times of 173 and 203 minutes and blood loss of 150 mL. No complications occurred. Patients were discharged after 31 and 38 hours, respectively. Histopathology confirmed RCC. At the 3-month follow-up, no complications or readmissions were reported. Second patient continued peritoneal dialysis without issues.

CONCLUSION:

Retroperitoneal SP-RARN via the lower anterior approach avoids the peritoneal cavity, making it suitable for certain patients. In these patients, more so than in others, this procedure is feasible, safe, and less morbid than the standard multiport approach.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Duração da Cirurgia / Procedimentos Cirúrgicos Robóticos / Neoplasias Renais / Nefrectomia Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Int Braz J Urol Assunto da revista: UROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Duração da Cirurgia / Procedimentos Cirúrgicos Robóticos / Neoplasias Renais / Nefrectomia Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Int Braz J Urol Assunto da revista: UROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Brasil