Robotic Assisted laparoscopic partial nephrectomy: our experience with 50 cases.

==inizio abstract==

Laparoscopic partial nephrectomy (LPN) is still one of the more challenging procedures in urology. Minimizing warm ischemia time (WIT) and bleeding requires efficient intracorporeal suturing. In addition, achieving negative surgical margins requires complete excision of the tumour. Robotic assisted partial nephrectomy adds to laparoscopy the advantages offered by the “Da Vinci system”, such as the 3-D vision and the better degree of freedom of surgical instruments. We report our experience with robotic assisted laparoscopic partial nephrectomy.
From August 2009 to October 2012,50 patients had robotic assisted partial nephrectomy for kidney cancer. All the procedures were performed with a transperitoneal approach. Ilar clamping was used in all cases: in 47 patients by one intracorporeal tourniquet for the artery and one more for the vein; in 3 cases case clamping was “en block” by Satinsky.
The average age of the patients (30 female, 20 male) was 63 (range 48-80). Average BMI was 25 (range 21.8 to 29.7).
The averagetumor size was 3.2 cm (range 2 – 6.7 cm); the mean operative time was 167.2 min (140 min – 250 min) with a mean warm ischemia time of 23.8 min (range 15 min – 28 min). The mean estimated blood loss was 260 ml (range 50 – 300 cc); 2 patients required 2 blood transfusion units.
In 1 patient nephrectomy was necessary because the tumor involved the renal pedicle. No more major intraoperative or postoperative complications were observed.
Pathologic examination revealed in all cases renal cell carcinoma. All resection margins were negative for tumor.
Partial nephrectomy has been facilitated by robotic technology that may enable surgeons to more frequently use nephron-sparing surgery. Robotic partial nephrectomy is safe and effective minimally invasive procedure

==fine abstract==