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Robotic partial nephrectomy

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https://www.readbyqxmd.com/read/28527565/-advancement-in-the-treatment-of-renal-carcinoma
#1
Arnaud Méjean
Partial nephrectomy is the gold standard for the renal tumours less than 7 to 10cm whenever feasible in order to preserve renal function. The extension of nephron-sparing surgery using a mini-invasive approach is possible by robotic surgery. Radical nephrectomy is mandatory in the other situations and especially in case of locally advanced renal carcinoma. The place of cytoreductive nephrectomy in metastatic renal cell carcinoma is the purpose of the CARMENA trial. Tyrosine kinase inhibitors are currently the first line treatment; but in the near future new immunotherapy by checkpoints molecules could crucially change the treatment of metastatic renal cell carcinoma...
May 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28503809/robot-assisted-laparoscopic-versus-open-partial-nephrectomy-in-patients-with-chronic-kidney-disease-a-propensity-score-matched-comparative-analysis-of-surgical-outcomes
#2
Toshio Takagi, Tsunenori Kondo, Hidekazu Tachibana, Junpei Iizuka, Kenji Omae, Hirohito Kobayashi, Kazuhiko Yoshida, Kazunari Tanabe
OBJECTIVES: To compare surgical outcomes between robot-assisted laparoscopic partial nephrectomy and open partial nephrectomy in patients with chronic kidney disease. METHODS: Of 550 patients who underwent partial nephrectomy between 2012 and 2015, 163 patients with T1-2 renal tumors who had an estimated glomerular filtration rate between 30 and 60 mL/min/1.73 m(2) , and underwent robot-assisted laparoscopic partial nephrectomy or open partial nephrectomy were retrospectively analyzed...
May 14, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28499759/trends-in-operating-room-assistance-for-major-urologic-surgical-procedures-an-increasing-role-for-advanced-practice-providers
#3
Amanda R Swanton, Ahmad N Alzubaidi, Yu Han, Kenneth G Nepple, Bradley A Erickson
OBJECTIVE: To characterize changes in surgical assistance patterns over time for commonly performed urologic operations. METHODS: This study used the Medicare Physician/Supplier Procedure Summary Master File to identify cases performed by urologists from 2003-2014. CPT modifiers were used to identify operations assisted by second surgeons and advanced practice providers (APPs). Rates were reported annually for six common urologic operations and average annual rates of change were determined using least squares regression and tested using t-tests (α=0...
May 9, 2017: Urology
https://www.readbyqxmd.com/read/28466073/completely-isolated-retroperitoneal-enteric-duplication-cyst-with-adenocarcinoma-transformation-managed-with-robotic-radical-nephrectomy
#4
Kassem Faraj, Luke Edwards, Alia Gupta, Brian Seifman
Background: Enteric duplication cysts are congenital malformations that typically affect children in infancy, but can also affect adults. Rarely, these cysts can be complicated by malignancy. We present the first case of retroperitoneal duplication cyst that was complicated by malignancy transformation and managed by robot-assisted excision. Case presentation: A 64-year-old female with a history of a left-sided renal cyst presented with a 4-month history of abdominal pain and fatigue. MRI revealed a bilobed cyst, with components measuring 6...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/28464554/does-the-training-of-fellows-affect-perioperative-outcomes-of-robotic-partial-nephrectomy
#5
Zine-Eddine Khene, Benoit Peyronnet, Elise Bosquet, Benjamin Pradère, Corentin Robert, Tarek Fardoun, Solène-Florence Kammerer-Jacquet, Grégory Verhoest, Nathalie Rioux-Leclercq, Romain Mathieu, Karim Bensalah
OBJECTIVE: To evaluate the impact of fellows' involvement on robot-assisted partial nephrectomy (RAPN) perioperative outcomes. MATERIALS AND METHODS: We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) or fellow operating under the supervision of the expert surgeon (fellow group). Perioperative data were compared between the two groups...
May 2, 2017: BJU International
https://www.readbyqxmd.com/read/28455799/periarterial-papaverine-to-treat-renal-artery-vasospasm-during-robot-assisted-laparoscopic-partial-nephrectomy
#6
Igor Sorokin, Sharnae L Stevens, Jeffrey A Cadeddu
Renal artery vasospasm can be a troublesome complication during robot-assisted laparoscopic partial nephrectomy. Urologists performing this procedure, especially if utilizing selective arterial vascular microdissection, should be aware of using papaverine for both prevention and treatment of renal artery vasospasm. We present a 33-year-old male who developed severe renal artery vasospasm just with hilar dissection causing the kidney to become ischemic. Papaverine was topically applied on the renal arteries resulting in vasodilation and reperfusion of the kidney...
April 28, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28437021/optimal-outcome-achievement-in-partial-nephrectomy-for-t1-renal-masses-a-contemporary-analysis-of-open-and-robotic-cases
#7
Matthew J Maurice, Daniel Ramirez, Önder Kara, Ercan Malkoç, Ryan J Nelson, Khaled Fareed, Robert J Stein, Amr F Fergany, Jihad H Kaouk
OBJECTIVES: To compare optimal outcome achievement between open and robotic partial nephrectomy. PATIENTS AND METHODS: Using our institutional partial nephrectomy database, we reviewed 605 cases performed for unifocal clinical T1 renal masses in non-solitary kidneys from 2011-2015. Tetrafecta, which was defined as negative surgical margins, freedom from perioperative complications, ≥80% renal functional preservation, and no chronic kidney disease upstaging, was chosen as the composite optimal outcome...
April 24, 2017: BJU International
https://www.readbyqxmd.com/read/28436368/-pseudo-pseudoaneurysm-following-robotic-assisted-partial-nephrectomy
#8
Eric Schommer, Julio Gundian, David D Thiel
A 65-year-old female presented to clinic requesting follow up for a history of right robotic partial nephrectomy done at an outside institution 2 years prior. Initial pathology demonstrated a grade 2/4 3.4 cm clear cell renal cell carcinoma with negative margins. There was no tumor necrosis, sarcomatoid differentiation, or lymphovascular invasion. High quality follow up imaging initially revealed a pseudoaneurysm in the central portion of the right kidney. The patient was sent to interventional radiology for angioembolization...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28400189/predicting-complications-following-robot-assisted-partial-nephrectomy-with-the-acs-nsqip-universal-surgical-risk-calculator
#9
Jared S Winoker, David J Paulucci, Harry Anastos, Nikhil Waingankar, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, John P Sfakianos, Ketan K Badani
PURPOSE: We evaluated the predictive value of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator in a tertiary referral cohort of patients undergoing robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We queried our prospectively maintained multi-institutional database of RAPN patients and input the preoperative details of 300 randomly selected patients into the calculator. Accuracy of the calculator was assessed by receiver-operator area under the curve (AUC) and also by Brier score (BS)...
April 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28380483/off-clamp-versus-on-clamp-robotic-partial-nephrectomy-a-multicenter-match-paired-case-control-study
#10
Benoit Peyronnet, Zine-Eddine Khene, Benjamin Pradère, Thomas Seisen, Grégory Verhoest, Alexandra Masson-Lecomte, Yohann Grassano, Mathieu Roumiguié, Jean-Baptiste Beauval, Hervé Baumert, Stéphane Droupy, Nicolas Doumerc, Jean-Christophe Bernhard, Christophe Vaessen, Franck Bruyère, Alexandre de la Taille, Morgan Rouprêt, Karim Bensalah
INTRODUCTION: The aim of this study was to compare the outcomes of on-clamp and off-clamp robotic partial nephrectomy (RPN). MATERIALS AND METHODS: The charts of all patients who underwent an RPN at 8 institutions between 2010 and 2014 were retrospectively reviewed. The patients who underwent an off-clamp RPN were matched to on-clamp RPN in a 1-4 fashion according to the following variables: RENAL score, tumor size and surgeon's experience. Pre-, intra-, and postoperative data were compared between both groups...
April 6, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28379673/hilar-parenchymal-oversew-a-novel-technique-for-robotic-partial-nephrectomy-hilar-tumor-renorrhaphy
#11
Jaya Sai S Chavali, Ryan Nelson, Matthew J Maurice, Onder Kara, Pascal Mouracade, Julien Dagenais, Jeremy Reese, Pilar Bayona, Georges-Pascal Haber, Robert J Stein
INTRODUCTION: A renorrhaphy technique which is effective for hemostasis but does not place undue tension on the branch vessels of the renal sinus remains one of the challenging steps after hilar tumor resection during robotic partial nephrectomy (RPN). The published V-hilar suture (VHS) technique is one option for reconstruction after an RPN involving the hilum. The objective of this video is to show a novel renorrhaphy technique, Hilar Parenchymal Oversew that has been effective for such cases...
April 6, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28352149/robot-assisted-partial-nephrectomy-for-t1b-tumors-strict-trifecta-outcomes
#12
Ilter Tufek, Panagiotis Mourmouris, Tunkut Doganca, Can Obek, Omer Burak Argun, Mustafa Bilal Tuna, Mehmet Selcuk Keskin, Ali Rıza Kural
BACKGROUND AND OBJECTIVES: "Trifecta" in partial nephrectomy consists of negative surgical margins, minimal renal function decrease and absence of complications. In the present article, our single-center robot-assisted partial nephrectomy (RAPN) experience in T1b renal masses is reported in terms of strict Trifecta outcomes. METHODS: This is a retrospective analysis of patients with a tumor diameter between 4 and 7 cm (stage T1b), who underwent RAPN by a single surgeon...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28341496/prospective-assessment-and-histological-analysis-of-adherent-perinephric-fat-in-partial-nephrectomies
#13
Charles Dariane, Thomas Le Guilchet, Sophie Hurel, François Audenet, Aurélien Beaugerie, Cécile Badoual, Joan Tordjman, Karine Clément, Saïk Urien, Michel Pietak, Eric Fontaine, Arnaud Méjean, Marc-Olivier Timsit
OBJECTIVES: The complexity of partial nephrectomy (PN) is partly anticipated by morphometric tumor-based scores that do not consider patient-related issues such as adherent perinephric fat (APF). Also, the objective is to prospectively assess the predictive factors of APF during PN, its effect on complications, and to correlate it to the histological reality. METHODS: A total of 125 consecutive patients undergoing robotic or open PN were prospectively included. The Mayo adhesive probability score (MAP score) was compared to the peroperative presence of APF defined by a score≥2...
February 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28319350/touching-the-future-three-dimensional-printing-facilitates-preoperative-planning-realistic-simulation-and-enhanced-precision-in-robot-assisted-laparoscopic-partial-nephrectomy
#14
EDITORIAL
Nicolò de Luyk, Benjamin Namdarian, Benjamin Challacombe
No abstract text is available yet for this article.
April 2017: BJU International
https://www.readbyqxmd.com/read/28319348/size-is-no-barrier-robot-assisted-partial-nephrectomy-in-patients-with-a-high-body-mass-index
#15
EDITORIAL
Benjamin Namdarian, Akshaya Rajangam, Benjamin Challacombe
No abstract text is available yet for this article.
April 2017: BJU International
https://www.readbyqxmd.com/read/28316935/anaphylactic-shock-after-intravenous-administration-of-indocyanine-green-during-robotic-partial-nephrectomy
#16
William Chu, Avinash Chennamsetty, Robert Toroussian, Clayton Lau
Indocyanine Green (ICG) is frequently used during urologic robotic procedures and is generally considered to be safe. However, there are reported cases of severe complications from ICG when used for non-urologic purposes. We present the first case to our knowledge of anaphylactic shock in response to intravenous ICG during a robotic partial nephrectomy.
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28315787/the-synergistic-influence-of-ischemic-time-and-surgical-precision-on-acute-kidney-injury-after-robotic-partial-nephrectomy
#17
Julien Dagenais, Matt Maurice, Pascal Mouracade, Onder Kara, Ryan Nelson, Ercan Malkoc, Jihad Kaouk
OBJECTIVES: To examine the dynamic and potentially synergistic influence of warm ischemia time (WIT) and excisional volume loss (EVL) on predicted rates of post-partial acute kidney injury (AKI) across a range of tumor complexities. To investigate whether these modifiable variables sensitize the kidney to the other's damaging influence. METHODS: We retrospectively reviewed 1,245 patients between 2006 and 2016 with bilateral kidneys and enhancing renal masses in our single-institution robotic partial nephrectomy (PN) database...
March 15, 2017: Urology
https://www.readbyqxmd.com/read/28303428/outcomes-of-laparoscopic-and-robotic-partial-nephrectomy-for-large-4%C3%A2-cm-kidney-tumors-systematic-review-and-meta-analysis
#18
REVIEW
Nicola Pavan, Ithaar H Derweesh, Carme Maria Mir, Giacomo Novara, Lance J Hampton, Matteo Ferro, Sisto Perdonà, Dipen J Parekh, Francesco Porpiglia, Riccardo Autorino
PURPOSE: The aim of this study was to assess the outcomes of minimally invasive (laparoscopic and robotic) partial nephrectomy (MIPN) for large renal masses. MATERIALS AND METHODS: A systematic literature review was performed up to September 2016 using multiple search engines to identify studies comparing MIPN for tumors larger than 4 cm (>cT1a) with MIPN for tumors smaller than 4 cm (cT1a). The preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria were used for article selection...
March 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28279366/-impact-of-robotic-assistance-on-the-use-and-the-outcomes-of-nephron-sparing-surgery-a-single-center-experience
#19
T Fardoun, B Peyronnet, E Oger, G Verhoest, R Mathieu, Z Khene, B Pradere, Q Alimi, A Manunta, N Rioux-Leclercq, J-J Patard, S-F Kammerer-Jacquet, K Bensalah
INTRODUCTION: The aim of this study was to assess the impact of the acquisition of a Da Vinci(®) robot on the use and outcomes of partial nephrectomy (PN). PATIENTS AND METHODS: It was a single center retrospective study including 280 patients who underwent PN from January 2006 to May 2013. The number of PN, tumors and patients' characteristics and perioperative outcomes have been assessed over 3 periods defined according to the main surgical approach: 2006-2008 (open PN), 2008-2010 (laparoscopic PN) and 2010-2013 (robotic PN)...
December 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/28266814/predicting-outcomes-in-partial-nephrectomy-is-the-renal-score-useful
#20
André Costa Matos, Marcos F Dall'Oglio, José Roberto Colombo, Alexandre Crippa, João A Q Juveniz, Felipe Coelho Argolo
INTRODUCTION AND OBJECTIVE: The R.E.N.A.L. nephrometry system (RNS) has been validated in multiple open, laparoscopic and robotic partial nephrectomy series. The aim of this study was to test the accuracy of R.E.N.A.L. nephrometry system in predicting perioperative outcomes in surgical treatment of kidney tumors <7.0cm in a prospective model. MATERIALS AND METHODS: Seventy-one patients were selected and included in this prospective study. We evaluate the accuracy of RNS in predicting perioperative outcomes (WIT, OT, EBL, LOS, conversion, complications and surgical margins) in partial nephrectomy using ROC curves, univariate and multivariate analyses...
May 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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