Novel Gerota-edge-sling technique facilitates retroperitoneal robot-assisted partial nephrectomy: a comparative study

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Retroperitoneal robotic partial nephrectomy faces challenges due to limited space and visual field.
• The Gerota-edge-sling (GES) technique was developed to address these limitations by attaching Gerota fascia to the abdominal wall.

Purpose of the Study:

• To introduce and evaluate the novel Gerota-edge-sling (GES) technique for retroperitoneal robotic partial nephrectomy.
• To compare the utilization and outcomes of the GES technique against the routine technique.

Main Methods:

• Retrospective analysis of 103 patients undergoing retroperitoneal robotic partial nephrectomy (March 2018 - June 2020).
• Patients were divided into a control group (routine technique) and a GES group.
• Perioperative outcomes, complications, and tumor subgroup comparisons were analyzed; linear regression assessed dissection time and perinephric fat.

Main Results:

• The GES group (55 patients) showed significantly decreased console time (91 min) and dissection time (67 min) compared to the control group (48 patients: 117 min and 93 min, respectively).
• No conversions or positive surgical margins occurred; ischemia time, blood loss, and nephrometry scores were comparable.
• GES technique demonstrated shorter dissection times in both anterior and posterior tumor subgroups.

Conclusions:

• The Gerota-edge-sling (GES) technique enhances surgical exposure and facilitates dissection in retroperitoneal partial nephrectomy.
• The GES technique is a feasible, effective, and safe adjunct to robotic arms, offering a space-sparing advantage.