Tumor enucleoresection in robot-assisted partial nephrectomy

Alexandre Mottrie, Nikolaos Koliakos, Geert Denaeyer, Pieter Willemsen, Nicolo Buffi, Peter Schatteman, Etienne Fonteyne

Research output: Contribution to journalArticle

Abstract

The objective of this study is to describe our technique and results of the enucleoresection technique in robot-assisted partial nephrectomy. The patient is positioned in full flank position. Three robotic arms of a da Vinci system and an assistant's port are used. The renal hilus is freed, the kidney mobilized and the site of the partial excision prepared. The vessels are clamped with a bulldog. The capsula of the kidney is incised circular about 5 mm around the tumor. A pseudocapsula of compressed healthy tissue around the tumor is found and mainly blunt dissection is done with the cold scissors. At the base of the dissection, the resection is completed sharply. Possible calyceal defects and major vessels are stitched. Fibrinogen coagulation enhancer and cellulose coagulation sponge are used to lessen the gap and the renal defect is closed with absorbable suture. The kidney is re-perfused and observed for bleeding. We have performed 17 cases with warm ischemia time 16-35 min (mean 24 min) and tumor size 2.2-5.3 cm (mean 3.8 cm). All surgical margins were tumor free. No postoperative complications were identified except one clot retention. Robot-assisted enucleoresection of kidney tumors is a feasible and very promising technique that needs to be further evaluated for results.

Original languageEnglish
Pages (from-to)65-69
Number of pages5
JournalJournal of Robotic Surgery
Volume3
Issue number2
DOIs
Publication statusPublished - Jun 2009

Keywords

  • Da Vinci robot
  • Enucleoresection
  • Minimal invasive
  • Partial nephrectomy
  • Renal cancer
  • Robot-assisted nephrectomy

ASJC Scopus subject areas

  • Surgery
  • Health Informatics

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  • Cite this

    Mottrie, A., Koliakos, N., Denaeyer, G., Willemsen, P., Buffi, N., Schatteman, P., & Fonteyne, E. (2009). Tumor enucleoresection in robot-assisted partial nephrectomy. Journal of Robotic Surgery, 3(2), 65-69. https://doi.org/10.1007/s11701-009-0136-8