V10-11 PARTIAL NEPHRECTOMY IN COMPLEX KIDNEY MASSES - TWO APPROACHES WITH THE DAVINCI SINGLE PORT ROBOT

Abstract

You have accessJournal of UrologyCME1 May 2022V10-11 PARTIAL NEPHRECTOMY IN COMPLEX KIDNEY MASSES - TWO APPROACHES WITH THE DAVINCI SINGLE PORT ROBOT John Sheng, Chrystal Chang, Michael Stifelman, and Mutahar Ahmed John ShengJohn Sheng More articles by this author , Chrystal ChangChrystal Chang More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , and Mutahar AhmedMutahar Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002623.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: - Performing partial nephrectomy on patients with complex hilar anatomy and/or posterior tumors can be challenging, sometimes requiring placement of an additional assistant port and/or mobilizing the entire kidney. - We demonstrate how the DaVinci Single Port Robot facilitates certain surgical approaches in performing partial nephrectomy on complex masses. - We show how the procedure can be performed with one incision with both a transperitoneal approach on a patient with complex hilar anatomy and an entirely retroperitoneal approach on another patient with a posterior mass. METHODS: Case - Transperitoneal Approach. - 41 year old male who was found to have an enhancing left 3cm hilar mass on workup for microhematuria. - He also has a duplicated collecting system on the same side as his mass. Case - Retroperitoneal Approach- 61 year old female who was found to have an enhancing 2cm left posterior kidney mass on workup for microhematuria. RESULTS: - For both approaches no additional assistant port was needed. - A single 15mm incision was made on the left side of the abdomen for the robotic instruments. No assistant port was used, making both true single port procedures. - For the retroperitoneal approach, we did not have to mobilize the entire kidney and then flip it medially which would have been needed with a multiport robotic approach. - We had quick access to the hilum and vasculature as well as the mass itself. - The patient had only one incision for both approaches, resulting in better cosmesis and possibly less post operative pain. CONCLUSIONS: - True single port partial nephrectomy can be performed via both a transperitoneal or retroperitoneal approach. This can be customized based on surgeon preference, comfort level and patient anatomy. - Its utilization can allow for the most minimally invasive approach, despite complex kidney anatomy. - However there is a learning curve in the use of the Da Vinci SP robot. - We hope to improve our techniques and surgical approaches further to keep our procedures as minimally invasive as possible. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e851 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Sheng More articles by this author Chrystal Chang More articles by this author Michael Stifelman More articles by this author Mutahar Ahmed More articles by this author Expand All Advertisement PDF DownloadLoading ...