Robot-assisted laparoscopic partial nephrectomy with hydrodissection
| Autor: | C.E. Estrada-Carrasco, J.J. Torres-Gómez, J.S. Izquierdo-Luna, J.G. Campos-Salcedo, J.C. López-Silvestre, M.A. Zapata-Villalba |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment 030232 urology & nephrology Robotic Surgical Procedures General Medicine medicine.disease Nephrectomy Surgery 03 medical and health sciences Dissection 0302 clinical medicine Clamp Robotic systems 030220 oncology & carcinogenesis medicine.artery medicine Cyst Renal artery business Laparoscopy |
| Zdroj: | Actas Urológicas Españolas (English Edition). 40:333-336 |
| ISSN: | 2173-5786 |
| DOI: | 10.1016/j.acuroe.2016.03.002 |
| Popis: | Introduction Nephron-sparing surgery is reporting satisfactory oncological results, with improved quality of life. The laparoscopic approach is technically complex and requires advanced skills; however, the use of robotic systems facilitates the transition to this procedure. With improved strategies for diagnosis and follow-up, as well as ablative technologies, the role of partial nephrectomy continuous to evolve. The use of water-jet technology to dissect and resect organs helps create anatomical planes in a relatively blood-free field, which improves vision and does not cause heat damage. Material and methods We present the case of a patient with an incidental diagnosis of a complex right renal cyst managed with robot-assisted laparoscopic partial nephrectomy using hydrodissection for tumor resection. Results The surgery was performed with 2 robotic arms. Four ports were routinely placed, the colon was mobilized, and the tumor was dissected. Tumor delimitation was performed with laparoscopic ultrasound, and the renal artery was clamped. We then performed the tumor resection assisted by a laparoscopic water-jet applicator, operated by the assistant through an auxiliary port. The renal parenchyma was reconstructed in 2 planes, without knots, and the arterial clamp was withdrawn at 23 min. The resection margins were negative. Conclusions The use of water-jet technology to assist with the renal tumor resection during minimally invasive nephron-sparing surgery facilitates the dissection, making it more fluid and atraumatic. Simultaneously, the technique provides a clean surgical field, which improves visibility. This procedure can help decrease ischemia times, thereby positively affecting the patient's evolution without compromising the oncological results. |
| Databáze: | OpenAIRE |
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