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Robotic nephrectomy for the treatment of benign and malignant disease
Author(s) -
Rogers Craig,
Laungani Rajesh,
Krane Louis Spencer,
Bhandari Akshay,
Bhandari Mahendra,
Me Mani
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.07895.x
Subject(s) - medicine , nephrectomy , surgery , renal cell carcinoma , chromophobe cell , malignancy , oncocytoma , kidney disease , kidney , clear cell
OBJECTIVES To report our experience and describe our technique of robotic nephrectomy. PATIENTS AND METHODS We retrospectively evaluated 42 patients who underwent robotic nephrectomy at our institution from January 2004 to March 2008. Variables assessed included patient age, body mass index, operative duration, estimated blood loss (EBL), complications, hospital stay, analgesia requirements and specimen pathology. Radical nephrectomy (RN) was performed for suspected malignant disease and simple nephrectomy (SN) was performed for benign disease. RESULTS In all, 42 patients with a mean (range) age of 59.4 (17–38) years, underwent robotic nephrectomy (RN 35, SN seven) using a transperitoneal (39) or retroperitoneal (three) approach. The mean operative console time was 158 min, mean EBL was 223 mL, mean tumour size was 5.1 cm, and the mean hospital stay was 2.4 days. Renal hilar vessels were controlled using robotic suture ligation (25), robotic haemolock clips (12), or laparoscopic staplers (five). No patients required open conversion. One morbidly obese patient developed a wound dehiscience (complication rate 2.6%). On final tumour pathology, the RN specimens included 34 renal cell carcinomas (clear cell 23, papillary nine, chromophobe two) and an oncocytoma. The SN specimens showed chronic xanthogranulomatous pyelonephritis (four) and atrophic kidneys (three). All surgical margins were negative for malignancy with no evidence of tumour recurrence at a mean (range) follow‐up of 15.7 (1–51) months. CONCLUSIONS Robotic nephrectomy is a safe and feasible option for minimally invasive surgical removal of the kidney for benign and malignant conditions and can be performed through a transperitoneal or retroperitoneal approach.