2008 Annual Meeting Abstracts
Robotic Assisted Laparoscopic Partial Nephrectomy: Initial clinical experience and technique for pathologic T1NoMo Renal Cell Carcinoma
Rosalia Viterbo, David Y Chen, Robert G Uzzo
Fox Chase Cancer Center, Philadelphia, PA
Introduction: Open nephron sparing surgery is an accepted treatment option for patients with small renal tumors, compromised renal function, and solitary kidneys. Laparoscopic partial nephrectomy is an alternative to open surgery. The DaVinci surgical system may make the laparoscopic partial nephrectomy more feasible allowing for more technically complex procedures and reduced ischemia time. We present our initial experience of 22 robotic partial nephrectomies (RALPN).
Methods We identified 20 consecutive patients with suspicious renal masses who underwent 22 overall procedures in a 7 month period. Intraoperative ultrasound was used to define the tumor margins, bulldog clamps used for vascular control, frozen sections were taken to assess margin status and reconstruction took place using several hemostatic agents.
Results 22 masses in 20 patients, 17 men and 5 women, median age 55yr, underwent RALPN. Median ischemia time was 30min. Median EBL was 100ml. Median LOS was 3 days. Median tumor size was 3.0cm. Pathology revealed clear cell in 8, papillary in 6, cystic RCC in 3, oncocytomas in 2, chromophobe in 2 and AML in 1. All resection margins were negative. 0 patients required intraoperative transfusions, 2 patients required postoperative transfusions. Baseline median creatinine was 1.1 and postoperative median creatinine was 1.1.
Conclusions: RALPN is a technically safe and feasible procedure that appears to be an alternative to laparoscopic and open partial nephrectomy. The DaVinci surgical system allows intracorporeal suturing and excision of renal masses with ease and precision required for reconstruction, along with added benefits of keeping ischemia time to a minimum.
