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Related Concept Videos

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Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...

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Updated: May 16, 2026

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
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"Trifecta" in partial nephrectomy.

Andrew J Hung1, Jie Cai, Matthew N Simmons

  • 1Hillard and Roclyn Herzog Center for Robotic Surgery, University of Southern California Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90089, USA.

The Journal of Urology
|November 21, 2012
PubMed
Summary
This summary is machine-generated.

Robotic partial nephrectomy achieved improved trifecta outcomes, including negative cancer margins, preserved kidney function, and no complications. This goal is increasingly realized despite more complex tumors over a 12-year period.

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Published on: March 12, 2011

Area of Science:

  • Urology
  • Surgical Oncology
  • Nephrology

Background:

  • Robotic/laparoscopic partial nephrectomy (RPN) is a standard treatment for renal tumors.
  • Achieving trifecta outcomes (negative margin, preserved function, no complications) is a key goal.
  • Serial outcomes data over time are crucial for evaluating surgical advancements.

Purpose of the Study:

  • To introduce and report serial trifecta outcomes in patients undergoing RPN for renal tumors.
  • To assess the impact of surgical technique evolution on trifecta outcomes over a 12-year period.

Main Methods:

  • Retrospective analysis of 534 patients treated with RPN between 1999 and 2011.
  • Patients were divided into four chronological eras based on surgical techniques (discovery, conventional clamping, early unclamping, zero ischemia).
  • Renal function was assessed by estimated glomerular filtration rate (eGFR) decrease (>10%).

Main Results:

  • Tumor size and complexity increased over the eras, yet kidney preservation remained high (88-90%).
  • Warm ischemia time significantly decreased (36 to 0 minutes), and renal functional outcomes improved.
  • Trifecta outcome achievement increased significantly in recent eras (45% to 68%), despite increasing tumor complexity.

Conclusions:

  • Trifecta outcomes should be a routine goal in partial nephrectomy.
  • Robotic/laparoscopic partial nephrectomy has demonstrated significant improvements in trifecta outcomes over the past decade.
  • Technical advancements have enabled better functional preservation and oncologic control in RPN.