The experience of robot-assisted and laparoscopic resection of kidney in condition of regional ischemia

Abstract

Introduction. The aim of the study is to share the experience in performing robotic and laparoscopic partial nephrectomy in the conditions of regional ischemia by placing a special surgical clamp on renal parenchyma or by selective clamping of segmental renal artery. We describe the main pros for performing regional ischemia, i. e. lower risk of acute kidney injury in the postoperative period. Matherials and methods. Laparoscopic and robot-assisted partial nephrectomy under regional ischemia was performed in 7 cases aged 35–72. The tumor size varied from 2 to 4 cm. Special surgical clamp was used in 6 cases and segmental renal artery clamping was performed in 1 case. Results. The operative time varied from 120 to 190 minutes, regional ischemia time was 13–30 minutes and blood loss — 30–270 ml. The were neither conversions nor complications. The serum creatinine level did not vary significantly before and after the procedure. Conclusion. Partial nephrectomy under regional ischemia prevents the onset of acute kidney injury. The special surgical clamp makes the surgery easier and reduce the operative time and blood loss.