Munich, Germany (UroToday.com) Robotic partial nephrectomy has emerged as an effective and safe treatment modality for the management of renal masses. Approach during partial nephrectomy can be performed via transperitoneal or retroperitoneal approach.
The retroperitoneal approach is considered a more challenging procedure due to a limited space in the retroperitoneal space, however this approach is beneficial to a group of patients who have posterior tumors that are more amenable for this retroperitoneal approach. Gambachidze and his colleagues performed a prospective analysis and compared perioperative outcomes for Retroperitoneal Robotic Partial Nephrectomy (RRPN) and Retroperitoneal Laparoscopic Partial Nephrectomy (RLPN).
This study included a total of 133 patients who underwent RRPN and RLPN between 1998 and 2015. Peri-operative variables were collected and analyzed.
A total of 38 patients underwent RRPN and 95 underwent RLPN. There were no significant differences in baseline characteristics of patient demographics and clinical characteristics. The researchers shares that the robotic approach provides shorter warm ischemia time, short operative time and significantly lower blood loss. There were no difference in conversion rates, positive surgical rates or length of hospital stay between the groups.
Although robotic retroperitoneal partial nephrectomy is considered a very challenging procedure due to port placement and limited space, Dr. Gambachidze concluded that RRPN is feasible and more efficacious compared to the laparoscopic procedure. The study demonstrated that the robot-assisted approach is associated with a significantly lower warm ischemia time, less blood loss and shorter operative time compare to RLPN. The robot-assisted should be the procedure of choice for the retroperitoneal management of renal masses.
Presented By: Dr. D. Gambachidze
Henri Mondor Academic Hospital, Dept. of Urology, Creteil, France
From the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany