Zero ischemia robotic partial nephrectomy: sequential preplaced suture renorrhaphy technique.

Area of Science:

• Urology
• Robotic Surgery
• Nephrology

Background:

• Renal ischemia during partial nephrectomy can impair kidney function.
• Minimizing blood loss and preserving renal parenchyma are critical surgical goals.

Purpose of the Study:

• To describe a novel robotic partial nephrectomy technique.
• The technique aims to eliminate global renal ischemia and decrease parenchymal bleeding.

Main Methods:

• A sequential preplaced suture renorrhaphy technique was employed.
• Sutures were placed through parenchyma adjacent to the tumor before resection.
• Resection and suturing occurred simultaneously to control bleeding and preserve tissue.

Main Results:

• The technique was performed on 14 patients with a median RENAL score of 6.5.
• Median estimated blood loss was 192.5 mL, with no Clavien grade 3 or 4 complications.
• Two patients experienced short warm ischemia times (14.5 and 15 minutes).

Conclusions:

• Sequential preplaced suture renorrhaphy is a safe and effective robotic partial nephrectomy method.
• This technique aids in renal function preservation by limiting warm ischemia time.
• It is particularly beneficial for patients with solitary kidneys and multiple tumors.