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Robot-assisted Partial Splenectomy
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Robotic Partial Nephrectomy for Complex Hilar Tumors: Step by step.

Jose Luis Bauza Quetglas1, Daniel Sagalovich2, Riccardo Bertolo2

  • 1Urology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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Robotic partial nephrectomy (RPN) successfully treated a complex, large renal mass involving the hilum. This advanced technique offers a viable option for challenging kidney cancer cases, preserving renal function.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Robotic surgery expands indications for conservative renal mass treatment.
  • Increasing experience allows robotic partial nephrectomy (RPN) for larger, complex tumors.

Purpose of the Study:

  • To detail the step-by-step technique for robotic partial nephrectomy (RPN) in a highly complex renal mass.
  • To provide insights and tips for performing RPN on challenging kidney tumors.

Main Methods:

  • A 7.6 cm complex renal mass (RENAL score 12) in a 78-year-old male was treated with RPN.
  • A transperitoneal approach with a three-arm robotic configuration was utilized.

Main Results:

  • The procedure took 195 minutes with a warm ischemia time of 19 minutes.
  • Negligible blood loss occurred, and serum creatinine remained stable post-operatively.
  • Final pathology confirmed clear cell renal cell carcinoma (pT3b, ISUP grade 3) with negative surgical margins.

Conclusions:

  • Robotic partial nephrectomy (RPN) is feasible for complex, endophytic, hilar renal masses.
  • Significant surgical experience is crucial for managing these challenging cases.
  • Further research is needed to establish long-term outcomes for RPN in complex renal tumors.