Robotic Partial Nephrectomy For Renal Hilar Tumors: A Multi-Institutional Analysis

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology;  Medical Devices / Diagnostics
Article Date: 30 Nov 2008 - 1:00 PDT

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UroToday.com - Our multi-institutional study on robotic partial nephrectomy for renal hilar tumors is the first to focus solely on renal hilar tumors and represents one of the largest series in the world.

Laparoscopic partial nephrectomy requires advanced skills in laparoscopy to achieve precise tumor resection and renal reconstruction while minimizing warm ischemia times and minimizing the risk of complications, such as urinary fistula and postoperative bleeding. Tumors located near renal hilar structures can add to the technical challenges of a laparoscopic partial nephrectomy.

Robotic assistance may facilitate the advanced maneuvers required to successfully perform partial nephrectomy in the setting of renal hilar tumors, potentially allowing patients to receive a minimally invasive approach to partial nephrectomy who might otherwise receive radical nephrectomy or open surgery. This study demonstrates the safety and efficacy of robotic partial nephrectomy in select patients with renal hilar tumors.

The goal of robotic partial nephrectomy, like open partial nephrectomy, includes providing cancer control while preserving long term renal functional outcomes. The robot adds efficiency to the procedure, allowing for rapid sewing that may shorten warm ischemic times.

We do not necessarily recommend that all renal hilar tumors be treated with robotic partial nephrectomy. Surgical teams should select the approach that will optimize the chance for a partial nephrectomy. However, a minimally invasive approach for perihilar tumors is feasible, and robotic assistance may facilitate the technical challenges involved.

Written by Craig Rogers, MD, as part of Beyond the Abstract on UroToday.com

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