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Robot-assisted Laparoscopic Partial Nephrectomy
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¹Ú¼º¿ ( Park Sung-Yul )
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¼ÁÖ¿Ï ( Seo Joo-Wan )
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³ª±ºÈ£ ( Rha Koon-Ho )
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ÇÔ¿ø½Ä ( Ham Won-Sik )
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±èÇüÁØ ( Kim Hyung-Joon )
¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ºñ´¢±â°úÇб³½Ç
Á¶°¼ö ( Cho Kang-Su )
¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ ºñ´¢±â°úÇб³½Ç, ºñ´¢ÀÇ°úÇבּ¸¼Ò
KMID : 0358320080490050387
Abstract
Purpose: Laparoscopic partial nephrectomy is a treatment option for small renal masses. However, such time-consuming techniques such as tumor excision, hemostasis and intracoporeal suturing are still challenging procedures even for experienced laparoscopists. Incorporation of a robotic system would facilitate tumor excision, hemostasis and intracoporeal suturing. Herein, we review our technique and the short term outcomes for robot-assisted laparoscopic partial nephrectomy(RLPN).
Materials and Methods: Eleven patients underwent RLPN for small renal masses. RLPN were performed with the da Vinci? robot system(Intuitive Surgical, Sunnyvale, USA) with three robot arms. In 7 cases, the renal hilum was clamped. Tumor excision and intracorporeal suturing were performed entirely with the robotic system. The specimen was extracted through the extended umbilical port incision.
Results: The mean tumor diameter was 2.5¡¾1.5cm. The mean operative time was 179.5¡¾49.4 minutes and the mean estimated blood loss was 354.5¡¾440.7ml. The mean warm ischemia time was 30.4¡¾5.9 minutes for 7 patients. There were no major complications. The surgical pathology showed clear cell type renal cell carcinoma in 7, papillary type renal cell carcinoma in 1, angiomyolipoma in 2 and lipoma in 1. There were no positive surgical margins. The mean hospital stay was 4.2¡¾1.3 days. No recurrence had been observed after 3 to 18 months of follow-up.
Conclusions: We were able to verify the feasibility and safety of using a RLPN in the management of small renal masses. Longer follow-up data and larger prospective studies are necessary to confirm these results.
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Robotics;Nephrectomy;Kidney neoplasms
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