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Updated: Jun 18, 2026

Robot-assisted Partial Splenectomy
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Robotic partial nephrectomy without renal hilar occlusion.

Wesley M White1, Raj K Goel, Georges-Pascal Haber

  • 1Cleveland Clinic, Glickman Urological Institute, The Cleveland Clinic Foundation, Glickman Urological, Institute, Cleveland, OH, USA.

BJU International
|November 26, 2009
PubMed
Summary
This summary is machine-generated.

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Robotic partial nephrectomy (RPN) without renal hilar clamping is safe for small renal masses. While estimated blood loss was higher, transfusion rates remained similar, indicating a viable alternative surgical approach.

Area of Science:

  • Urology
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Robotic partial nephrectomy (RPN) is a minimally invasive technique for kidney tumor removal.
  • Renal hilar clamping is commonly used to minimize blood loss during RPN.
  • The safety and efficacy of RPN performed without renal hilar clamping require further evaluation.

Purpose of the Study:

  • To assess the operative outcomes of robotic partial nephrectomy (RPN) conducted without renal hilar clamping.
  • To compare the outcomes of RPN without clamping to RPN with clamping.

Main Methods:

  • A prospective observational study of patients undergoing RPN under perfused conditions (pRPN).
  • Patients with solitary, enhancing renal cortical lesions were included.
  • Comparison was made to a contemporary RPN group with renal hilar occlusion, analyzing operative time, blood loss, and complications.

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Main Results:

  • The pRPN group had a shorter operative time (P = 0.035) but greater estimated blood loss (EBL) (P = 0.018) compared to the clamped RPN group.
  • All patients achieved negative pathological margins.
  • No significant difference was observed in transfusion rates or renal function between the groups.

Conclusions:

  • Robotic partial nephrectomy without renal hilar occlusion is a safe option for selected small renal cortical masses.
  • Although pRPN may result in higher EBL, it does not significantly increase the need for transfusions.
  • This technique offers a viable alternative for kidney-sparing surgery.