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Contemporary Surgical Approaches for Small Renal Tumors

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Diagnosis and Surgical Management of Renal Tumors

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Abstract

Nephron-sparing surgery with partial nephrectomy is currently the mainstay of treatment for patients presenting with a small renal mass. In recent years, laparoscopic and robotic techniques have been developed for performing partial nephrectomy. These techniques have resulted in shorter hospital stays, less postoperative pain, better cosmetic results, and equivalent oncologic outcomes to open surgery. In this chapter we review contemporary minimally invasive approaches for the treatment of small renal tumors with partial nephrectomy.

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References

  1. Ljunberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, et al. EAU guidelines on renal cell carcinoma. Eur Urol. 2015;67(5):913–24.

    Article  Google Scholar 

  2. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, et al. Renal mass and localized renal cancer: AUA guideline. J Urol. 2017;198(3):520–9.

    Article  Google Scholar 

  3. Mir MC, Ercole C, Takagi C, Zhang Z, Velet L, Remer EM, et al. Decline in renal function after partial nephrectomy: etiology and prevention. J Urol. 2015;193(6):1889–98.

    Article  Google Scholar 

  4. Mir MC, Campbell RA, Sharma N, Remer EM, Simmon MN, Li J, et al. Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology. 2013;82:263.

    Article  Google Scholar 

  5. Simmons MN, Hillyer SP, Lee BH, Fergany AF, Kaouk J, Campbell S. Functional recovery after partial nephrectomy: effects of volume loss and ischemic injury. J Urol. 2012;187:1667.

    Article  Google Scholar 

  6. Herr HW. A history of partial nephrectomy for renal tumros. J Urol. 2005;173(3):705–8.

    Article  Google Scholar 

  7. Herr HW. Surgical management of renal tumors: a historical perspective. Urol Clin North Am. 2008;35(4):543–9.

    Article  Google Scholar 

  8. Patel SG, Penson DF, Pabla B, Clark PE, Cookson MS, Chang SS, et al. National trends in the use of partial nephrectomy: a rising tide that has not lifted all boats. J Urol. 2012;187(3):816–21.

    Article  Google Scholar 

  9. Peyronnet B, Selsen T, Oger E, Vaessen C, Grassano Y, Benoit T, et al. Comparison of 1800 robotic and open partial nephrectomies for renal tumors. Ann Surg Oncol. 2016;23(13):4277–83.

    Article  Google Scholar 

  10. Wang Y, Shao J, Ma X, Du Q, Gong H, Zhang X. Robotic and open partial nephrectomy for complex renal tumors: a matched-pair comparison with a long-term follow up. World J Urol. 2017;35(1):72–80.

    Google Scholar 

  11. Boy A, Hein J, Bollow M, Lazica D, Roosen A, Ubrig B. Minimally invasive vs open partial nephrectomy: perioperative success and complications rates. Urologe A. 2018. https://doi.org/10.1007/S00120-018-0646.

  12. Malkoc E, Ramirez D, Kara O, Maurice MJ, Nelson RJ, Caputo PA, et al. Robotic and open partial nephrectomy for localized renal tumors larger than 7cm: a single center experience. World J Urol. 2017;35(5):781–7.

    Article  Google Scholar 

  13. Kara O, Maurice MJ, Malkoc E, Ramirez D, Nelson RJ, Caputo PA, et al. Comparison of robot-assisted and open partial nephrectomy for completely endophytic renal tumours: a single centre experience. BJU Int. 2016;118(6):946–51.

    Article  Google Scholar 

  14. Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146:278.

    Article  CAS  Google Scholar 

  15. Jordan GH, Winslow BH. Laparoendoscopic upper pole partial nephrectomy with ureterectomy. J Urol. 1993;150(3):940–3.

    Article  CAS  Google Scholar 

  16. Benway RM, Wang AJ, Cabello JM, Bhayani SB. Robotic partial nephrectomy with sliding-clip renorrhaphy: techniques and outcomes. Eur Urol. 2009;55(3):592–9.

    Article  Google Scholar 

  17. Spana G, Haber GP, Dulabon LM, Petros F, et al. Complications after robotic partial nephrectomy at centers of excellence: multi-institutional analysis of 450 cases. J Urol. 2011;186(2):417–21.

    Article  Google Scholar 

  18. Wheat JC, Roberts WW, Hollenbeck, et al. Complications of laparoscopic partial nephrectomy. Urol Oncol. 2013;31(1):57–62.

    Article  Google Scholar 

  19. Pavan N, Derweesh IH, Hamplton L, White W, Porter JR, Challacombe B, et al. Retroperitoneal robotic partial nephrectomy: systematic review and cumulative analysis of comparative outcomes. J Endourol. 2018. https://doi.org/10.1089/en.d2018.0211.

  20. Gettman MT, Blute ML, Chow GK, Neururer R, Bartsch G, Peschel R. Robotiic-assisted laparoscopic partial nephrectomy: technique and initial experience with DaVinci robotic system. Urology. 2004;64(5):914–8.

    Article  Google Scholar 

  21. Mottrie A, De Naeyer G, Schatteman P, Carpentier P, Sangalli M, Ficarra V. Impact of the learning curve on perioperative outcomes in patients who underwent robotic partial nephrectomy for parenchymal renal tumours. Eur Urol. 2010;58(1):127–32.

    Article  Google Scholar 

  22. Ficarra V, Bhayani S, Porter J, Buffi N, Lee R, Cestari A, Mottrie A. Predictors of warm ischemia time and perioperative complications in a multicenter, international series of robot-assisted partial nephrectomy. Eur Urol. 2012;61(2):395–402.

    Article  Google Scholar 

  23. Krane LS, Manny TB, Mufarrij PW, et al. Does experience creating a robot-assisted partial nephrectomy (RAPN) programme in an academic entre impact outcomes or complication rate? BJU Int. 2013;112:207.

    Article  Google Scholar 

  24. Lavery HJ, Small AC, Samadi DB, Palese MA. Transition from laparoscopic to robotic partial nephrectomy: the learning curve for an experienced laparoscopic surgeon. JSLS. 2011;15:291–7.

    Article  Google Scholar 

  25. Kallingal G, Swain S, Darwiche F, Punnen S, Manoharan M, Gonzalgo ML, Parekh DJ. Robotic partial nephrectomy with the da Vinci Xi. Adv Urol. 2016;2016:9675095. https://doi.org/10.1155/2016/9675095.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Abdel Raheem A, Sheikh A, Kim DK, Alatawi A, Alabdulaali I, Han WK, Choi YD, Rha KH. Da Vinci Xi and Si platforms have equivalent perioperative outcomes during robot-assisted partial nephrectomy: preliminary experience. J Robot Surg. 2017;11(1):53–61.

    Article  Google Scholar 

  27. Volpe A, Blute ML, Ficarra V, Gill IS, Kutikov A, Porpiglia F, et al. Renal ischemia and function after partial nephrectomy: a collaborative review of the literature. Eur Urol. 2015;68(1):61–74.

    Article  Google Scholar 

  28. Porpiglia F, Fiori C, Bertolo R, Angusti T, Piccoli GB, Podio V, et al. The effects of warm ischaemia time on renal function after laparoscopic partial nephrectomy in patients with normal contralateral kidney. World J Urol. 2012;30(2):257–63.

    Article  Google Scholar 

  29. Russo P. Partial nephrectomy for renal cancer (part II): the impact of renal ischaemia, patient preparation, surgical approaches, management of complications and utilization. BJU Int. 2010;105(11):1494–507.

    Article  Google Scholar 

  30. Becker F, Van Poppel H, Hakenberg OW, et al. Assessing the impact of ischemia time during partial nephrectomy. Eur Urol. 2009;56:624–35.

    Article  Google Scholar 

  31. Simmons MN, Liser GC, Fergany AF, et al. Association between warm ischemia time and renal parenchymal atrophy after partial nephrectomy. J Urol. 2013;189:1638–42.

    Article  Google Scholar 

  32. Stubenitsky BM, Ametani M, Danielewicz R, et al. Regeneration of ATP in kidney slices after warm ischemia and hypothermic preservation. Transpl Int. 1995;8:293–7.

    Article  CAS  Google Scholar 

  33. Saitz TR, Dorsey PJ, Colli J, Lee BR. Induction of cold ischemia in patients with solitary kidney using retrograde intrarenal cooling: 2-year functional outcomes. Int Urol Nephrol. 2013;45:313–20.

    Article  Google Scholar 

  34. Schoeppler GM, Klippstein E, Hell J, et al. Prolonged cold ischemia time for laparoscopic partial nephrectomy with a new cooling material: Freka-Gelice – a comparison of four cooling methods. J Endourol. 2003;170:52–6.

    Google Scholar 

  35. Kijvikai K, Viprakasit DP, Milhoua P, et al. A simple, effective method to create laparoscopic renal protective hypothermia with cold saline surface irrigation: clinical application and assessment. J Urol. 2010;184:1861–6.

    Article  Google Scholar 

  36. Rogers CG, Ghani KR, Kumar RK, et al. Robotic partial nephrectomy with cold ischemia and on-clamp tumor extraction: recapitulating the open approach. Eur Urol. 2013;63:573–8.

    Article  Google Scholar 

  37. Kaouk JH, Samarasekera D, Krishnan J, et al. Robotic partial nephrectomy with intracorporeal renal hypothermia using ice slush. Urology. 2014;84:712–8.

    Article  Google Scholar 

  38. Ramirez D, Caputo PA, Krishnan J, Zargar H, Kaouk JH. Robot-assisted partial nephrectomy with intracorporeal renal hypothermia using ice slush: step-by-step and matched comparison with warm ischemia. BJU Int. 2016;117(3):531–6.

    Article  CAS  Google Scholar 

  39. Van den Berg NS, van Leeuwen FW, van der Poel HG. Fluorescence guidance in urologic surgery. Curr Opin Urol. 2012;22:109–20.

    Article  Google Scholar 

  40. McClintock TR, Bjurlin MA, Wysock JS, Borofsky MS, Marien TP, Okoro C, et al. Can selective arterial clamping with fluorescence imaging preserver kidney function during robotic partial nephrectomy? Urology. 2014;84(2):327–34.

    Article  Google Scholar 

  41. Marano A, Priora F, Lenti LM. Application of fluorescence in robotic general surgery: review of the literature and state of the art. World J Surg. 2013;37:2800–11.

    Article  Google Scholar 

  42. Tobis S, Knopf J, Silver C, Yao J, Rashid H, Wu G, et al. Near infrared fluorescence imaging with robotic assisted laparoscopic partial nephrectomy: initial experience for renal cortical tumors. J Urol. 2011;186(1):47–52.

    Article  Google Scholar 

  43. Bjurlin MA, McClintock TR, Stifelman MD. Near-infrared fluorescence imaging with intraoperative administration of indocyanine green for robotic partial nephrectomy. Curr Urol Rep. 2015;16(4):20.

    Article  Google Scholar 

  44. Raman JD, Bensalah K, Stern JM, Cadeddu JA. Laboratory and clinical development of single keyhole umbilical nephrectomy. Urology. 2007;70(6):1039–42.

    Article  Google Scholar 

  45. Rane A, Rao P, Bonadio F. Single port laparoscopic nephrectomy using a novel laparoscopic port (R-port) and evolution of single laparoscopic port procedure (SLIPP). J Endourol. 2007;21:A287.

    Google Scholar 

  46. Desai MM, Raoo PP, Aron M, Pascal-Haber G, Desai MR, Mishra S, et al. Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int. 2008;101:83–8.

    Article  Google Scholar 

  47. Kaouk JH, Goel RK, Haber GP, Crouzet S, Stein RJ. Robotic single-port transumbilical surgery in humans: initial report. BJU Int. 2008;103:366–9.

    Article  Google Scholar 

  48. White MA, Autorino R, Spana G, Hillyer S, Stein RJ, Kaouk JH. Robotic laparoendoscopic single site urological surgery: analysis of 50 consecutive cases. J Urol. 2012;187:1696–701.

    Article  Google Scholar 

  49. Seidman CA, Yong KT, Faddegon S, et al. Robot-assisted laparoendoscopic single-site pyeloplasty: technique using the da Vinci Si robotic platform. J Endourol. 2012;26:971–4.

    Article  Google Scholar 

  50. Joseph RA, Goh AC, Cuevas SP, et al. Chopstick surgery: a novel technique improves surgeon performance and eliminates arm collision in robotic- single incision laparoscopic surgery. Surg Endosc. 2010;24:13331–5.

    Google Scholar 

  51. White MA, Autorino R, Spana G, Laydner H, Hillyer SP, Khanna R, Yang B, Alunrende F, Isac W, Stein RJ, Haber GP, Kaouk JH. Robotic laparoendoscopic single-site radical nephrectomy: surgical technique and comparative outcomes. Eur Urol. 2011;59(5):815–22.

    Article  Google Scholar 

  52. Kaouk JH, Haber GP, Autorino R, Crouzet S, Ouzzane A, Flamand V, Villers A. A novel robotic system for single-port urologic surgery: first clinical investigation. Eur Urol. 2014;66:1033–43.

    Article  Google Scholar 

  53. Maurice MJ, Kaouk JH. Robotic radical perineal cystectomy and extended pelvic lymphadenectomy: initial investigations using a purpose-built single-port robotic system. BJU Int. 2017;120(6):881–4.

    Article  Google Scholar 

  54. Kaouk J, Sagalovich D, Garisto J. Robotic Transvesical Partial prostatectomy using a purpose built single port robotic system. BJU Int. 2018. https://doi.org/10.1111/bju.14194.

    Article  Google Scholar 

  55. Ramirez D, Maurice MJ, Kaouk JH. Robotic perineal radical prostatectomy and pelvic lymph node dissection using a purpose-built single-port robotic platform. BJU Int. 2016;118(5):829–33. https://doi.org/10.1111/bju.13581. Epub 2016 Sep 3

    Article  PubMed  Google Scholar 

  56. Maurice MJ, Ramirez D, Kaouk JH. Robotic laparoendoscopic single-site retroperitoneal renal surgery: initial investigation of a purpose-built single-port surgical system. Eur Urol. 2017;71(4):663–4.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Urology and Minimal Invasive Surgery, Strasbourg University Hospital, Strasbourg, France

    Pascal Mouracade

  2. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

    Juan Garisto & Jihad Kaouk

Authors
  1. Pascal Mouracade
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  2. Juan Garisto
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  3. Jihad Kaouk
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Corresponding author

Correspondence to Jihad Kaouk .

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Editors and Affiliations

  1. The James Buchanan Brady Urological, Institute and Department of Urology, Johns Hopkins University School of Medic, Baltimore, MD, USA

    Michael A. Gorin

  2. The James Buchanan Brady Urological, Institute and Department of Urology, Johns Hopkins University School of Medic, Baltimore, MD, USA

    Mohamad E. Allaf

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Mouracade, P., Garisto, J., Kaouk, J. (2019). Contemporary Surgical Approaches for Small Renal Tumors. In: Gorin, M., Allaf, M. (eds) Diagnosis and Surgical Management of Renal Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-92309-3_8

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  • DOI: https://doi.org/10.1007/978-3-319-92309-3_8

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  • Online ISBN: 978-3-319-92309-3

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