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Updated: Sep 30, 2025

Robot-Assisted Kidney Transplantation

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Published on: July 19, 2021

[Robot-assisted partial nephrectomy with selective ischemia].

B G Guliev^1,2, B K Komyakov^1,2, Kh Kh Yagubov^1,2

¹Department of urology of North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia.

Urologiia (Moscow, Russia : 1999)

|March 11, 2022

Summary

Robot-assisted partial nephrectomy (RAPN) using selective renal ischemia is effective for most kidney tumors. This approach minimizes kidney damage by clamping only the tumor

Keywords:

Da Vinci robot partial nephrectomy renal cell cancer renal ischemia robot-assisted partial nephrectomy selective ischemia

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Area of Science:

Urology
Surgical Oncology
Nephrology

Background:

Clamping the renal artery during partial nephrectomy causes renal ischemia and function decline.
Selective clamping of the segmental renal artery supplying the tumor offers an alternative to total renal ischemia.

Purpose of the Study:

To evaluate the efficacy and safety of robot-assisted partial nephrectomy (RAPN) employing selective renal ischemia.
To assess the impact of selective ischemia on renal function and oncological outcomes.

Main Methods:

42 patients with T1a/T1b renal tumors underwent RAPN with selective renal artery clamping.
CT angiography and 3D reconstruction identified tumor-supplying segmental arteries.
RENAL nephrometric scale assessed tumor complexity; complications were graded using Clavien-Dindo classification.

Main Results:

Selective ischemia was successful in 90.5% of RAPN cases.
Mean operative time was 130 minutes, blood loss 185 ml, and warm ischemia time 14 minutes.
Postoperative renal function (glomerular filtration rate) showed no significant decline (p>0.05).

Conclusions:

Preoperative mapping of renal arterial anatomy enables precise identification of tumor-supplying segmental branches.
Selective clamping of these branches allows for effective and safe RAPN, avoiding total renal ischemia.
This technique preserves renal function and achieves successful oncological control.