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Journal of Robotic Surgery

, Volume 2, Issue 3, pp 141–143 | Cite as

Robotic partial nephrectomy: a multi-institutional analysis

  • C. G. Rogers
  • M. Menon
  • E. S. Weise
  • M. T. Gettman
  • I. Frank
  • D. L. Shephard
  • H. M. Abrahams
  • J. M. Green
  • D. J. Savatta
  • S. B. Bhayani
Original Article

Abstract

Laparoscopic partial nephrectomy for kidney tumors has demonstrated durable oncologic and functional outcomes. The feasibility of robotic partial nephrectomy (RPN) has been demonstrated in several small, single-institution studies. We performed a large, multi-institutional analysis to determine early oncologic results and perioperative outcomes after RPN. Between October, 2002 and September, 2007, 148 patients underwent RPN at six different centers by nine different primary surgeons for localized renal tumors. Medical and operative records were reviewed for clinical characteristics, pathologic findings, and follow-up information. A total of 148 patients underwent RPN. Mean tumor size was 2.8 cm. Renal hilar clamping was utilized in 120 patients, with a mean warm ischemia time of 27.8 min. Positive surgical margins were identified in six patients (4%), of which two had cautery artifact obscuring the margin after off-clamp cautery excision and one underwent completion radical nephrectomy with no evidence of cancer. There is no evidence of tumor recurrence at mean follow-up of 7.2 months (range 2–54 months) overall, and mean follow-up of 18 months (range 12–23 months) for patients with positive surgical margin. Complications occurred in nine patients (6.1%), including hematoma requiring drainage (n = 1), prolonged ileus (n = 3), pulmonary embolus (n = 2), prolonged urine leak (n = 2), and rhabdomyolysis (n = 1). Two patients underwent open conversion for failure to progress, one patient with morbid obesity and one patient with adhesions from prior ureterolithotomy. Mean hospital stay was 1.9 days. In this multi-institutional series of surgeons beginning their initial experience in RPN, the procedure is a feasible option for minimally invasive, nephron-sparing surgery, with immediate oncologic results and perioperative outcomes comparable with more mature laparoscopic series.

Keywords

Kidney cancer Laparoscopy Partial nephrectomy Robotics Technique 

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Copyright information

© Springer-Verlag London Ltd 2008

Authors and Affiliations

  • C. G. Rogers
    • 1
  • M. Menon
    • 1
  • E. S. Weise
    • 2
  • M. T. Gettman
    • 3
  • I. Frank
    • 3
  • D. L. Shephard
    • 4
  • H. M. Abrahams
    • 4
  • J. M. Green
    • 4
  • D. J. Savatta
    • 5
  • S. B. Bhayani
    • 6
  1. 1.Vattikuti Urology InstituteHenry Ford HospitalDetroitUSA
  2. 2.Northeast Indiana UrologyFort WayneUSA
  3. 3.Department of UrologyMayo ClinicRochesterUSA
  4. 4.Urology Associates of North TexasArlingtonUSA
  5. 5.Associates in UrologyLLCWest OrangeUSA
  6. 6.Washington University School of MedicineSt LouisUSA

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