Early Experience in Da Vinci Robot-Assisted Partial Nephrectomy: An Australian Single Centre Series

Abstract

Introduction and Objectives. To demonstrate the safety and efficacy of the robot-assisted partial nephrectomy (RAPN) technique in an Australian setting. Methods. Between November 2010 and July 2014, a total of 76 patients underwent 77 RAPN procedures using the Da Vinci Surgical System© at our institution. 58 of these procedures were performed primarily by the senior author (PB) and are described in this case series. Results. Median operative time was 4 hours (range 1.5–6) and median warm ischaemic time (WIT) was 8 minutes (range 0–30) including 11 cases with zero ischaemic time. All surgical margins were clear with the exception of one patient who had egress of intravascular microscopic tumour outside the capsule to the point of the resection margin. Complications were identified in 9 patients (15.8%). Major complications included conversion to open surgery due to significant venous bleeding (n = 1), reperfusion injury (n = 1), gluteal compartment syndrome (n = 1), DVT/PE (n = 1), and readmission for haematuria (n = 1). Conclusion. This series demonstrates the safety and efficacy of the RAPN technique in an Australian setting when performed by experienced laparoscopic surgeons in a dedicated high volume robotic centre.

‘A pain in the buttock’: A case report of gluteal compartment syndrome after robotic partial nephrectomy

“…A MEDLINE search for ‘gluteal compartment syndrome’ limited to English-language articles published in the past ten years indicates that perioperative occurrence of gluteal compartment syndrome has most often been described after orthopaedic surgery and vascular surgery (Table 1). To the best of our knowledge, there has only been one other reported case of GCS after renal surgery (Ting et al 2015).…”

“… BMI: body mass index; AAA: abdominal aortic aneurysm; BMI: body mass index; EVAR: endovascular aneurysm repair; NR: not reported. References: Benevides & Nochi Júnior (2006); Cameron-Gagné et al (2018); Chew et al (2009); Hau et al (2016); Keene et al (2010); Kumar et al (2007); Matta & Kelley (2014); Mohanty et al (2019); O’Leary et al (2010); Oates et al (2016); Osteen & Haque (2012); Pereira & Heath (2015); Polacek et al (2009); Pua et al (2005); Reisiger et al (2005); Rudolph et al (2011); Sarwar & Ting (2017); Somayaji et al (2005); Ting et al (2015); Viviani et al (2016). …”