Retroperitoneal approach for robot-assisted partial nephrectomy: technique and early outcomes

Porreca, Angelo; D’Agostino, Daniele; Dente, D.; Dandrea, Matteo; Salvaggio, A.; Cappa, E.; Zuccala, A.; Rosso, Alessandro Del; Chessa, F.; Romagnoli, Daniele; Mengoni, Francesco; Borghesi, Marco; Schiavina, Riccardo

doi:10.1590/s1677-5538.ibju.2017.0104

Cited by 17 publications

(6 citation statements)

References 14 publications

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“…In the thoracic cage, the robotic-assisted sympathetic trunk has shown its feasibility and the outcome is satisfied, however there are still some procedures worthy to develop, such as intercostal nerve and phrenic nerve intervention, or thoracic outlet decompression by removing the first rib. In the retroperitoneum, robotic-assisted nephrectomy/ lymphadenectomy, hysterectomy and lumbar sympathectomy are widely reported, 13,45,46 however, robotic-assisted nerve surgery is still rare. Many studies discussed nerve-sparing techniques in robotic-assisted prostatectomy, however, robotic nerve intervention was rarely studied, such as pudendal nerve reconstruction after oncological resection, or complicated neurogenic tumor excision.…”

Section: Brachial Plexus Reconstructionmentioning

confidence: 99%

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Chen

Goh

Goh³

et al. 2021

J Reconstr Microsurg

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Background Robotic-assisted techniques are a tremendous revolution in modern surgery, and the advantages and indications were well discussed in different specialties. However, the use of robotic technique in plastic and reconstructive surgery is still very limited, especially in the field of peripheral nerve reconstruction. This study aims to identify current clinical applications for peripheral nerve reconstruction, and to evaluate the advantages and disadvantages to establish potential uses in the future. Methods A review was conducted in the literatures from PubMed focusing on currently published robotic peripheral nerve intervention techniques. Eligible studies included related animal model, cadaveric and human studies. Reviews on robotic microsurgical technique unrelated to peripheral nerve intervention and non-English articles were excluded. The differences of wound assessment and nerve management between robotic-assisted and conventional approach were compared. Results Total 19 studies including preclinical experimental researches and clinical reports were listed and classified into brachial plexus reconstruction, peripheral nerve tumors management, peripheral nerve decompression or repair, peripheral nerve harvesting, and sympathetic trunk reconstruction. There were three animal studies, four cadaveric studies, eight clinical series, and four studies demonstrating clinical, animal, or cadaveric studies simultaneously. In total 53 clinical cases, only 20 (37.7%) cases were successfully approached with minimal invasive and intervened robotically; 17 (32.1%) cases underwent conventional approach and the nerves were intervened robotically; 12 (22.6%) cases converted to open approach but still intervened the nerve by robot; and 4 (7.5%) cases failed to approach robotically and converted to open surgery entirely. Conclusion Robotic-assisted surgery is still in the early stage in peripheral nerve surgery. We believe the use of the robotic system in this field will develop to become popular in the future, especially in the fields that need cooperation with other specialties to provide the solutions for challenging circumstances.

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Section: Brachial Plexus Reconstructionmentioning

confidence: 99%

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Chen

Goh

Goh³

et al. 2021

J Reconstr Microsurg

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“…The primary advantage of the retroperitoneal approach is direct access to the renal artery [ 32 ], which is crucial when there is persistent renal bleeding. Furthermore, the retroperitoneal approach minimizes the risk of abdominal organ damage and abdominal adhesions and accelerates the postoperative recovery of intestinal function [ 33 ]. Notably, surgical field metastases have been reported after laparoscopic transperitoneal partial nephrectomy in patients with WS due to renal cell carcinoma [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Nontraumatic Spontaneous Renal Hemorrhage (Wünderlich Syndrome) through Robotic-Assisted Laparoscopic Nephrectomy: A Case Series

Tao,

Zhang,

Zhang

et al. 2024

Am J Case Rep

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Case series Patients: Female, 44-year-old • Female, 56-year-old • Male, 45-year-old Final Diagnosis: Wünderlich syndrome Symptoms: Flank pain Clinical Procedure: — Specialty: Urology Objective: Rare disease Background: Wünderlich syndrome (WS) is a rare diagnosis of nontraumatic spontaneous renal hemorrhage into the subcapsular, perirenal, or pararenal spaces. Prompt and effective intervention is necessary for an accurate pathological diagnosis and preservation of life. In the current literature, open surgery is the primary option when conservative treatment fails, but there can be serious trauma and corresponding consequences. Herein, we present 3 cases of Wünderlich syndrome managed by robot-assisted laparoscopic nephrectomy via a retroperitoneal approach. Case Reports: Patient 1 was a 44-year-old woman with right flank pain for 6 h. Patient 2 was a 53-year-old woman with a history of diabetes who had pain in her right flank pain and nausea for 1 day. Patient 3 was a 45-year-old man with left flank pain for 1 day. All cases of WS were confirmed by CT. All 3 patients were treated with retroperitoneal robot-assisted nephrectomy after conservative treatment failed. Pathological examination confirmed that patient 1 had angiomyolipoma, and patients 2 and 3 had renal clear cell carcinoma. At the 9-month follow-up, renal function was good and no evidence of recurrence or metastasis has been detected. Conclusions: These cases have highlighted the importance of the clinical history and imaging findings in the diagnosis of Wünderlich syndrome, and show that rapid management can be achieved using robot-assisted laparoscopic nephrectomy. However, it is crucial to have a skilled surgical team and adequate preoperative preparation.

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“…However, some surgeons transferring from retroperitoneal laparoscopic surgery may feel suitably experienced in translating skills to perform retroperitoneal robotic surgery. Guides are available on performing retroperitoneal RAPN [27,28].…”

Section: Surgical Techniquementioning

confidence: 99%

Robot-Assisted Partial Nephrectomy: Evolving Techniques

Quraishi¹,

Latif²,

Thomas³

et al. 2020

Evolving Trends in Kidney Cancer

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Robotic-assisted partial nephrectomy is now embraced in urology as a recommended treatment option for small localised renal tumours. There is an increasing trend towards setting up robotic-assisted services in urological centres across the world. Our aim is to review the available published common robotic-assisted partial nephrectomy techniques. We present our institutions' established step-by-step technique for performing robotic-assisted partial nephrectomy, in order to guide aspiring urologists interested in performing robotic-assisted partial nephrectomies. The importance of pre-operative review of imaging in a multidisciplinary approach is critical. We emphasise certain tips inperforming a safer procedure.

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Retroperitoneal approach for robot-assisted partial nephrectomy: technique and early outcomes

Cited by 17 publications

References 14 publications

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Management of Nontraumatic Spontaneous Renal Hemorrhage (Wünderlich Syndrome) through Robotic-Assisted Laparoscopic Nephrectomy: A Case Series

Robot-Assisted Partial Nephrectomy: Evolving Techniques

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