Robot-assisted Partial Nephrectomy with Segmental Renal Artery Clamping: A Single Center Experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Renal tumors necessitate effective surgical management to preserve kidney function.
• Partial nephrectomy is the gold standard for localized renal tumors.
• Vascular control during partial nephrectomy is critical to minimize blood loss and ischemia.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of robotic partial nephrectomy (RPN) utilizing segmental clamping of tumor-feeding arteries.
• To assess the safety and oncological outcomes of this specific vascular control strategy.

Main Methods:

• A retrospective analysis of 36 patients undergoing RPN with segmental renal artery clamping.
• Data collected included operative time, blood loss, warm ischemia time, and complications (Clavien-Dindo).
• Renal function and oncological outcomes were analyzed pre- and post-operatively.

Main Results:

• The mean tumor size was 40 mm with a R.E.N.A.L. nephrometry score of 6.74.
• Mean operative time, blood loss, and warm ischemia time were 162 minutes, 236 ml, and 16 minutes, respectively.
• The segmental artery clamping technique had a success rate of 94.4% (34/36), with no significant difference in pre- and post-operative renal function (P=.18).

Conclusions:

• Segmental renal artery clamping is a reliable and effective method for vascular control in RPN.
• Preoperative contrast-enhanced CT with 3-D reconstruction is essential for precise evaluation of tumor and vascular anatomy.
• This technique contributes to successful partial nephrectomy while preserving renal function.