Radiofrequency Ablation–Assisted Robotic Laparoscopic Partial Nephrectomy Without Renal Hilar Vessel Clamping Versus Laparoscopic Partial Nephrectomy: A Comparison of Perioperative Outcomes

Abstract

The use of RFA-assistance during robotic partial nephrectomy allows excision of renal tumors without hilar vascular clamping, thus eliminating renal warm ischemia. Larger and more centrally located tumors were excised with RF-RCPN. No differences in blood loss, complication rate, postoperative bleeding, renal function, or recurrence rate were noted compared with LPN.

Robotic-assisted laparoscopic cryo-partial nephrectomy: a novel technique using cryoablation in lieu of hilar clamping in a porcine model

“…The use of radiofrequency ablation is the most promising [24][25][26][27][28]. Wu et al [29] recently reported on the use of the Habib 4 £ RFA device to coagulate a margin of normal parenchyma around the renal mass to allow excision of the mass within a bloodless plane in 42 patients . The average size of the tumor treated was 2.8 cm and average EBL was 337 ml.…”

Radiofrequency Coagulation-Assisted Laparoscopic Partial Nephrectomy Without Hilar Clamping: A Feasible Technique With Excellent Outcomes in Highly Selected Patients

“…We cannot directly compare studies using the RFC device with different methodologies, but there is some current progress of note in managing small renal masses, as summarized in Table 2. In a recently published study, Wu and associates 13 analyzed the use of Habib-assisted robot-assisted PN in 42 patients for tumors of similar nature and patients at similar risk of renal disease. 13 Mean OR time for this group of patients was 373 minutes, while Nadler and colleagues 12 reported a median OR time of 435 minutes with their robotic approach (although patient and tumor characteristics were not provided).…”

“…As such, it has been described in experimental porcine models 10 and OPN series, 11 but only a few reports exist describing the usefulness in LPN with a limited number of patients. 9,12,13 In this study, we retrospectively review a series of patients who underwent clampless LPN with RFC to study the safety and feasibility of this approach.…”

Laparoscopic Partial Nephrectomy – Current State of the Art

“…Wu et al [68] have recently published a series comparing 36 patients undergoing LPN with hilar clamping to 42 patients undergoing RFA-assisted robotic clampless partial nephrectomy. Tumors were larger in the RFA group (2.8 vs. 2.0cm), more often endophytic (52.6% vs. 16.1%) and collecting system reconstruction occurred more often (78.6% vs. 30.6%).…”