Skip to main content
SpringerLink
Log in

Robotic partial nephrectomy: our first 30 consecutive cases

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

We present our initial outcomes of robotic assisted laparoscopic partial nephrectomy (RALPN) at our centre. All data were collected prospectively. The transperitoneal approach was used in all our cases. The clinical parameters recorded include warm ischemia time (WIT), clampless procedures, estimated blood loss (EBL), operative time, length of stay (LOS) and oncological outcomes including positive surgical margins (PSM). The Clavien−Dindo system was used for grading complications. Thirty patients with a mean age of 56.7 years (ranging between 25 and 81 years) underwent RPN between January 2010 and November 2013. The mean tumour size was 2.48 cm (range, 1.3−5.5 cm) of which 54 % were right renal tumours (n = 16) and 46 % (n = 14) were left renal tumours. The mean operative time was 217.5 min (170−260 min) and the mean console time was 164.3 min (120−210 min). The mean EBL was 140.2 ml (10−1,500 ml) and the mean WIT was 16.1 min (0−34 min). Ten percent of patients (n = 3) underwent clampless RPN and no postoperative transfusion was required. The mean LOS was 4 days (3−9) and only one patient (3 %) had positive surgical margins (PSM). The incidence of major complications was 3 % (one patient) who had a DVT following surgery (3 %). Our preliminary results show that RALPN is a safe technique with minimal complications. Longer follow-up and larger patient numbers are required to validate these results further.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Touijer K, Jacqmin D, Kavoussi LR et al (2010) The expanding role of partial nephrectomy: a critical analysis of indications, results, and complications. Eur Urol 57:214

    Article  PubMed  Google Scholar 

  2. McKiernan J, Simmons R, Katz J et al (2002) Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology 59:816–820

    Article  PubMed  Google Scholar 

  3. Lau WK, Blute ML, Weaver AL et al (2000) Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc 75:1236–1242

    Article  CAS  PubMed  Google Scholar 

  4. Snow DC, Bhayani SB (2008) Rapid communication: chronic renal insufficiency after laparoscopic partial nephrectomy and radical nephrectomy for pathologic t1a lesions. J Endourol 22:337–341

    Article  PubMed  Google Scholar 

  5. Vasdev N, Giessing M, Zengini H, Adshead JM, Rabenalt R (2014) Robotic versus traditional laparoscopic partial nephrectomy: comparison of outcomes with a transition of techniques. J Robot Surg 8(2):157–161

    Article  Google Scholar 

  6. Aron M, Koenig P, Kaouk JH et al (2008) Robotic and laparoscopic partial nephrectomy: a matched-pair comparison from a high-volume centre. BJU Int 102:86

    Article  PubMed  Google Scholar 

  7. Kural AR, Atug F, Tufek I et al (2009) Robot-assisted partial nephrectomy versus laparoscopic partial nephrectomy: comparison of outcomes. J Endourol 23:1491

    Article  PubMed  Google Scholar 

  8. Haber GP, White WM, Crouzet S et al (2010) Robotic versus laparoscopic partial nephrectomy: single-surgeon matched cohort study of 150 patients. Urology 76:754

    Article  PubMed  Google Scholar 

  9. DeLong JM, Shapiro O, Moinzadeh A (2010) Comparison of laparoscopic versus robotic assisted partial nephrectomy: one surgeon’s initial experience. Can J Urol 17:5207

    PubMed  Google Scholar 

  10. Mottrie A, De Naeyer G, Schatteman P et al (2010) Impact of the learning curve on perioperative outcomes in patients who underwent robotic partial nephrectomy for parenchymal renal tumours. Eur Urol 58:127

    Article  PubMed  Google Scholar 

  11. Gettman MT, Blute ML, Chow GK et al (2004) Robotic-assisted laparoscopic partial nephrectomy: technique and initial clinical experience with Da Vinci robotic system. Urology 64:914–918

    Article  PubMed  Google Scholar 

  12. Wang AJ, Bhayani SB (2009) Robotic partial nephrectomy versus laparoscopic partial nephrectomy for renal cell carcinoma: single-surgeon analysis of >100 consecutive procedures. Urology 73(2):306–310

    Article  PubMed  Google Scholar 

  13. Deane LA, Lee HJ, Box GN et al (2008) Robotic versus standard laparoscopic partial/wedge nephrectomy: a comparison of intraoperative and perioperative results from a single institution. J Endourol 22:947

    Article  PubMed  Google Scholar 

  14. Caruso RP, Phillips CK, Kau E, Stifelman MD et al (2006) Robot assisted laparoscopic partial nephrectomy: initial experience. J Urol 176:36–39

    Article  PubMed  Google Scholar 

  15. Yohannes P, Rotariu P, Pinto P et al (2002) Comparison of robotic versus laparoscopic skills: is there a difference in the learning curve? Urology 60:39–45

    Article  PubMed  Google Scholar 

  16. Uzzo RG, Novick AC (2001) Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 166:6–18

    Article  CAS  PubMed  Google Scholar 

  17. Gong EM, Orvieto MA, Zorn KC et al (2008) Comparison of laparoscopic and open partial nephrectomy in clinical T1a renal tumors. J Endoruol 22:953–957

    Article  Google Scholar 

  18. Gill IS, Kavoussi LR, Lane BR et al (2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 178:41–46

    Article  PubMed  Google Scholar 

  19. Hollenbeck BK, Taub DA, Miller DC et al (2006) National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization? Urology 67:254–259

    Article  PubMed  Google Scholar 

  20. Rogers CG, Singh A, Blatt AM et al (2008) Robotic partial nephrectomy for complex renal tumors: surgical technique. Eur Urol 53:514–523

    Article  PubMed Central  PubMed  Google Scholar 

  21. Benway BM, Wang AJ, Cabello JM et al (2009) Robotic partial nephrectomy with sliding-clip renorrhaphy: technique and outcomes. Eur Urol 55:592

    Article  PubMed  Google Scholar 

  22. Bhayani SB, Figenshau RS (2008) The Washington University renorrhaphy for robotic partial nephrectomy: a detailed description of the technique displayed at the 2008 World Robotic Urologic Symposium. J Robot Surg 2:139–140

    Article  Google Scholar 

  23. Ha¨cker A, Albadour A, Jauker W et al (2007) Nephron-sparing surgery for renal tumours: acceleration and facilitation of the laparoscopic technique. Eur Urol 51(2):358–365

    Article  Google Scholar 

  24. DeLong JM, Shapiro O, Moinzadeh A (2010) Comparison of laparoscopic versus robotic assisted partial nephrectomy: one surgeon’s initial experience. Can J Urol 17(3):5207–5212

    PubMed  Google Scholar 

  25. Cho CL, Ho KL, Chu SS, Tam PC (2011) Robot-assisted versus standard laparoscopic partial nephrectomy: comparison of perioperative outcomes from a single institution. Hong Kong Med J 17(1):33–38

    Article  CAS  PubMed  Google Scholar 

  26. Leslie S, Goh AC, Gill IS (2013) Partial nephrectomy—contemporary indications, techniques and outcomes. Nat Rev Urol 10(5):275–283

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Ahmed Abroaf, Nikhil Vasdev, Gowrie Mohan S, James M Adshead declare that they have no conflict of interest.

Ethical standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Department of Urology, Hertfordshire and South Bedfordshire Robotic Urological Centre, Lister Hospital, Stevenage, UK

    Ahmed Abroaf, Nikhil Vasdev & J. M. Adshead

  2. Department of Anaesthetists, Lister Hospital, Stevenage, UK

    S. Gowrie Mohan

Authors
  1. Ahmed Abroaf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nikhil Vasdev
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Gowrie Mohan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. M. Adshead
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nikhil Vasdev.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abroaf, A., Vasdev, N., Mohan, S.G. et al. Robotic partial nephrectomy: our first 30 consecutive cases. J Robotic Surg 8, 337–341 (2014). https://doi.org/10.1007/s11701-014-0476-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-014-0476-x

Keywords

Search

Navigation