Off-clamp tumor excision using soft coagulation in laparoscopic and robotic partial nephrectomy.

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Assessing perioperative outcomes of off-clamp tumor excision using soft coagulation.
• Evaluating laparoscopic and robotic partial nephrectomy techniques.

Purpose of the Study:

• To evaluate the safety and feasibility of off-clamp tumor excision with soft coagulation.
• To compare outcomes of laparoscopic versus robotic partial nephrectomy using this technique.

Main Methods:

• Retrospective analysis of 78 patients undergoing minimally invasive partial nephrectomy.
• Utilizing soft coagulation for tumor excision and hemostasis without renal arterial clamping.
• Collecting system repair and renorrhaphy performed with clamping only if the collecting system was opened.

Main Results:

• Median estimated blood loss was 73 mL; no transfusions were required.
• No postoperative hemorrhagic events occurred; 6 patients had urinary fistulas requiring stenting.
• Median estimated glomerular filtration rate change was -7.2% at 1-3 months post-surgery.

Conclusions:

• Off-clamp soft coagulation is a safe and feasible technique for laparoscopic and robotic partial nephrectomy.
• This method may decrease the incidence of perioperative hemorrhagic complications.
• The technique shows promise for effective kidney tumor excision with preserved renal function.