Robot‐assisted laparoscopic partial nephrectomy using the selective clamping approach

Introduction and Objectives To demonstrate the technique of robot‐assisted laparoscopic partial nephrectomy (RAPN) using the selective clamping approach. Materials and Methods A 56‐year‐old man presented with a 1.9 cm middle pole anterior right renal mass. Imaging studies demonstrated it to be likel...

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Bibliographic Details
Published in:Surgical practice 2020-11, Vol.24 (4), p.160-161
Main Authors: Wong, Ting‐Fung, Lam, Wayne, Tsang, Chiu‐Fung, Ho, Brian Sze‐Ho, Ng, Ada Tsui‐Lin, Tsu, James Hok‐Leung
Format: Article
Language:English
Subjects:
CAS
Computer assisted surgery
Ischemia
Kidney cancer
Kidneys
Laparoscopy
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Summary:Introduction and Objectives To demonstrate the technique of robot‐assisted laparoscopic partial nephrectomy (RAPN) using the selective clamping approach. Materials and Methods A 56‐year‐old man presented with a 1.9 cm middle pole anterior right renal mass. Imaging studies demonstrated it to be likely a renal cell carcinoma. Transperitoneal RAPN was performed with intraoperative identification of an arterial branch supplying the region containing the renal tumour. Selective clamping of the polar branch was achieved, resulting in zero global renal ischaemia during the procedure. Results Operative time was 2.5 hours with estimated blood loss 30 mL. Patient made an uneventful recovery and was discharged on postoperative day four. Pathology confirmed pT1aG2 clear cell carcinoma with clear margins. Conclusion The selective clamping approach is an optimal strategy during RAPN and should be adopted if possible, to avoid global renal ischaemia. Meticulous dissection of the hilar vessels is essential to identify arterial branches for selective clamping.
ISSN:1744-1625
1744-1633
DOI:10.1111/1744-1633.12458