Analysis of surgical and histopathological results of robot-assisted partial nephrectomy with use of three or four robotic arms: an early series results

Abstract

Objectives: The aim of this study was to evaluate whether criteria exist to guide election between the use the three-or four-arm technique in robotic partial nephrectomy (RPN) instead of just the surgeon's preference. Material and Methods: We performed a retrospective review of 80 patients submitted to RPN from May 2016 to February 2020. The patients were divided into two groups of 40, the fi rst submitted to the surgical procedure with use of three robotic arms and the second with four arms. The group division was performed independently of the complexity of the cases, age or gender of the patients and laterality of the renal lesions. Peri-and postoperative data were analyzed for comparison between the two groups. Results: Both techniques had similar oncological outcomes (positive tumor margins), renal function preservation (warm ischemia time) and hemorrhagic complications (estimated blood loss and renal artery pseudoaneurysm), with a small difference in the need for blood transfusion, favoring the technique with three arms. Conclusions: The two robotic partial nephrectomy techniques had similar oncological and postoperative outcomes, with minimal perioperative complications. The threearm technique is safe and feasible regardless of the complexity and size of the tumor. Additionally, the use of the three-arm technique reduced surgery costs by US$ 413.00 per patient.

Robotic salvage partial nephrectomy following surgical and ablative therapies

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Purpose: Partial nephrectomies in the salvage setting after ablative or surgical therapy remain challenging cases that are underreported in the literature ( 1 - 5 ). The aim of this video is to demonstrate techniques for robotic salvage partial nephrectomy to manage recurrent renal cell carcinoma (RCC) after failed prior partial nephrectomy and primary cryotherapy.

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Upper tract urothelial carcinoma and bladder cancer in review in this number of International Brazilian Journal of Urology

“…Dr. Schulze and colleagues from Brazil performed in page 493 an important report about robotic surgery (7). The authors evaluated whether criteria exist to guide election between the use the three-or four-arm technique in robotic partial nephrectomy (RPN) instead of just the surgeon's preference and concluded that the two robotic partial nephrectomy techniques had similar oncological and postoperative outcomes, with minimal perioperative complications.…”