Simplified Zero Ischemia in Robot Assisted Partial Nephrectomy: Initial Yonsei Experience
½ÅÅ¿µ, ÃÖ°æÈ, Lim Sey-Kiat, ±è±¤Çö, À̵¿ÈÆ, ÀÌÁÖ¿ë, ÇÑ¿õ±Ô, ³ª±ºÈ£, ¿À¿µÅÃ, Á¤Âù±Ç,
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½ÅÅ¿µ ( Shin Tae-Young )
Yonsei University College of Medicine Department of Urology
ÃÖ°æÈ ( Choi Kyung-Hwa )
Yonsei University College of Medicine Department of Urology
( Lim Sey-Kiat )
Yonsei University College of Medicine Department of Urology
±è±¤Çö ( Kim Kwang-Hyun )
Yonsei University College of Medicine Department of Urology
À̵¿ÈÆ ( Lee Dong-Hoon )
Yonsei University College of Medicine Department of Urology
ÀÌÁÖ¿ë ( Lee Joo-Yong )
Yonsei University College of Medicine Department of Urology
ÇÑ¿õ±Ô ( Han Woong-Kyu )
Yonsei University College of Medicine Department of Urology
³ª±ºÈ£ ( Rha Koon-Ho )
Yonsei University College of Medicine Department of Urology
¿À¿µÅà ( Oh Young-Taik )
Yonsei University College of Medicine Department of Radiology
Á¤Âù±Ç ( Jung Chan-Kwon )
Yonsei University College of Medicine Department of Radiology
KMID : 0358320130540020078
Abstract
Purpose: To evaluate the safety and feasibility of a simplified zero ischemia technique using kidney donor computed tomographic (CT) angiography and conventional laparoscopic bulldog clamps.
Materials and Methods: We conducted a review of seven robot-assisted partial nephrectomies (RAPNs) performed by a single surgeon from January 2012 to May 2012. Using a simplified protocol of 3-dimentional reconstruction, tertiary arterial branches supplying the tumor were selectively clamped prior to resection. We used conventional laparoscopic bulldog clamps instead of microsurgical vessel clamps. The patients¡¯ demographic information, perioperative outcomes, pathologic outcomes and pre- and postoperative renal functions up to 3 months follow-up were analyzed.
Results: RAPN were successfully performed for seven complex renal hilar tumors. There were no significant differences in the total operation time, estimated blood loss or postoperative outcomes compared with published literature on standard RAPN. Negative surgical margins were reported in all cases.
Conclusions: We presented a simplified-zero ischemia technique using kidney Donor CT angiography and conventional laparoscopic bulldog clamps. We have also demonstrated its safety and feasibility in patients with complex renal hilar tumors. This modified technique can be easily adopted by most surgeons who are currently performing RAPN.
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Kidney cancer;Nephrectomy;Robotics;Three-dimensional image
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