[Hybrid operating room: For what?]

Area of Science:

• Urology
• Interventional Radiology
• Surgical Innovation

Background:

• Renal cancer is often diagnosed at a localized stage, with nephron-sparing surgery being the primary treatment.
• Partial nephrectomy typically requires renal pedicle clamping, which can have long-term effects on kidney function and carries risks like pseudoaneurysm.
• Hybrid operating rooms (HOR) integrate interventional radiology and surgical equipment, facilitating advanced minimally invasive procedures.

Purpose of the Study:

• To develop and evaluate a new laparoscopic partial nephrectomy technique for localized renal cancer.
• To eliminate the need for renal pedicle clamping and associated ischemia during partial nephrectomy.
• To leverage the capabilities of hybrid operating rooms for combined endovascular and surgical interventions.

Main Methods:

• Developed a novel technique involving selective embolization of tumor vessels via an endovascular route immediately before surgery.
• Utilized hybrid operating rooms to simultaneously perform endovascular embolization and laparoscopic partial nephrectomy.
• Employed tumor staining with Patent Blue to enhance visualization and surgical precision.

Main Results:

• Successfully performed partial nephrectomy without clamping or approaching the renal pedicle, thus avoiding ischemia.
• Demonstrated the feasibility of combining endovascular embolization and laparoscopic surgery within a hybrid operating room setting.
• Highlighted the potential of this technique to mitigate complications associated with traditional renal pedicle clamping.

Conclusions:

• Hybrid operating rooms offer a new paradigm for managing localized renal cancer by integrating interventional radiology and surgery.
• This innovative partial nephrectomy technique represents a significant advancement, potentially applicable to other urological surgeries.
• The combination of expertise and technology in HORs paves the way for more minimally invasive and effective cancer treatments.