A Hybrid Retroperitoneal-Transperitoneal Approach for Robot-Assisted Radical Nephrectomy: A Technical Report of Two...

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical nephrectomy (RARN) offers minimally invasive options for kidney cancer.
• Standard transperitoneal and retroperitoneal approaches have limitations, especially with complex hilar anatomy or post-therapy fibrosis.

Purpose of the Study:

• To evaluate a hybrid RARN approach combining retroperitoneal and transperitoneal techniques.
• To assess the feasibility and outcomes of this hybrid method in challenging renal cell carcinoma cases.

Main Methods:

• A hybrid RARN procedure was performed in two patients with renal cell carcinoma.
• The technique involved initial retroperitoneal dissection for hilar control, followed by transperitoneal nephrectomy for tumor resection.

Main Results:

• The hybrid approach provided secure vascular control and adequate working space.
• Perioperative outcomes were comparable to conventional RARN procedures.
• This method was successfully applied in a case with post-systemic therapy fibrosis.

Conclusions:

• The hybrid RARN approach enhances surgical flexibility and safety.
• It offers a viable solution for complex renal cell carcinoma cases where standard approaches may be limited.