67th Annual Meeting Abstracts

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Robotic Assisted Laparoscopic Partial Nephrectomy: A Review of Surgical Outcomes from a Single Institution’s Initial Experience
*Keith Christiansen, Reza Ghasemian, *Keith Kowalczyk, John H Lynch, Mohan Verghese, Jonathan Hwang
Washington Hospital Center/Georgetown Univ. Hospital, Washington, DC

Introduction:
With recent advances in robotic surgical technology, robot assisted laparoscopic partial nephrectomy is quickly gaining widespread acceptance in managing small renal tumors. Herein, we report on the initial 2 year experience with robotic assisted laparoscopic partial nephrectomy (RLPN) at one institution and compare the outcomes to that of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) approaches during the concurrent time period.
Materials & Methods:
A retrospective review was conducted on all partial nephrectomies performed at a single institution from July 2006 to September 2008. Records were compared between 21 pts undergoing RLPNs, 20 pts undergoing LPNs and 26 pts undergoing OPNs. Various parameters analyzed included tumor size, estimated blood loss, operative and ischemia time, length of stay (LOS), final pathology and perioperative complications.
Results:
The mean tumor sizes of patients treated were 3.1 cm in RLPN group, 2.6 cm in LPN group and 3.4 cm in OPN group. Overall, there was no significant difference among the three groups in regard to the operative time, ischemia time, positive margin rate and complication rates. The EBL and length of stay were significantly less in the RLPN and LPN groups compared to the OPN group. There were no conversions from RLPN to open and only one conversion from lap to open in this series.
Conclusions:
Robotic assisted laparoscopic partial nephrectomy is an acceptable and feasible approach for T1 renal lesions. In our experience, RLPN can provide patients the benefit of minimally invasive nephron sparing surgery without compromising any oncological principles.

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