Hook-wire assisted localization of a completely endophytic renal mass during three-dimensional laparoscopic partial nephrectomy: Presentation of our technique

2021 ◽  
pp. 039156032110318
Author(s):  
Nikolaos Ferakis ◽  
Spyridon Paparidis ◽  
Athanasios Papatheodorou ◽  
Evangelos N Symeonidis ◽  
Antonios Katsimantas
Keyword(s):  
Partial Nephrectomy ◽  
Renal Mass ◽  
Three Dimensional ◽  
Cost Effective ◽  
Surgical Excision ◽  
Laparoscopic Partial Nephrectomy ◽  
Cell Renal Cell Carcinoma ◽  
Renal Masses ◽  
Case Presentation ◽  
Hook Wire

Introduction: Totally endophytic renal masses may be invisible during laparoscopic partial nephrectomy, posing challenge to surgeons regarding tumor’s identification and resection. Case presentation: A 22-year-old male was incidentally diagnosed with a completely endophytic, cT1a renal mass. Percutaneous Computed Tomography-guided insertion of a hook-wire was performed prior to laparoscopic partial nephrectomy. The hook-wire anchored centrally into the tumor and its extra-renal part was easily identified intraoperatively, contributing to tumor’s identification and surgical excision. Total operative time was 185 min, warm ischemia time was 21.5 min, tumor excision time was 10 min, and total renorraphy time was 31 min. No complications were encountered perioperatively. The patient was discharged on the fourth postoperative day. Histology revealed a pT1a, clear-cell renal cell carcinoma, with negative surgical margins. Conclusions: Our first experience indicates that hook-wire guided excision of a completely endophytic renal mass during laparoscopic partial nephrectomy is feasible, safe, and cost-effective.

scholarly journals Case Report: Optimizing Pre- and Intraoperative Planning With Hyperaccuracy Three-Dimensional Virtual Models for a Challenging Case of Robotic Partial Nephrectomy for Two Complex Renal Masses in a Horseshoe Kidney

2021 ◽  
Vol 8 ◽  
Author(s):  
Riccardo Campi ◽  
Francesco Sessa ◽  
Anna Rivetti ◽  
Alessio Pecoraro ◽  
Paolo Barzaghi ◽  
...  
Keyword(s):  
Decision Making ◽  
Partial Nephrectomy ◽  
Renal Mass ◽  
Three Dimensional ◽  
Horseshoe Kidney ◽  
Renal Tumors ◽  
Robotic Partial Nephrectomy ◽  
Renal Masses ◽  
Virtual Models ◽  
Intraoperative Planning

Objective: To report a case of robot-assisted partial nephrectomy (RAPN) for two highly complex renal tumors in a patient with a Horseshoe kidney (HSK), focusing on the utility of hyperaccuracy three-dimensional (HA3D) virtual models for accurate preoperative and intraoperative planning of the procedure.Methods: A 74-year-old Caucasian male patient was referred to our Unit for incidental detection of two complex renal masses in the left portion of a HSK. The 50 × 55 mm, larger, predominantly exophytic renal mass was located at the middle-lower pole of the left-sided kidney (PADUA score 9). The 16 × 17 mm, smaller, hilar renal mass was located at the middle-higher pole of the left-sided kidney (PADUA score 9). Contrast-enhanced CT scan images in DICOM format were processed using a dedicated software to achieve a HA3D virtual reconstructions. RAPN was performed by a highly experienced surgeon using the da Vinci Si robotic platform with a three-arm configuration. A selective delayed clamping strategy was adopted for resection of the larger renal mass while a clampless strategy was adopted for the smaller renal mass. An enucleative resection strategy was pursued for both tumors.Results: The overall operative time was 150 min, with a warm ischemia time of 21 min. No intraoperative or postoperative complications were recorded. Final resection technique according to the SIB score was pure enucleation for both masses. At histopathological analysis, both renal masses were clear cell renal cell carcinoma (ccRCC) (stage pT1bNxMx and pT3aNxMx for the larger and smaller mass, respectively). At a follow-up of 7 months, there was no evidence of local or systemic recurrence.Conclusions: Surgical management of complex renal masses in patients with HSKs is challenging and decision-making is highly nuanced. To optimize postoperative outcomes, proper surgical experience and careful preoperative planning are key. In this regard, 3D models can play a crucial role to refine patient counseling, surgical decision-making, and pre- and intraoperative planning during RAPN, tailoring surgical strategies and techniques according to the single patient's anatomy.

1290: Laparoscopic Partial Nephrectomy (LPN) for Renal Mass: Washington University Experience with 99 Cases

2004 ◽  
Vol 171 (4S) ◽  
pp. 340-340 ◽  
Author(s):  
Caroline D. Ames ◽  
David Lieber ◽  
Ramakrishna Venkatesh ◽  
Richard Vanlangendock ◽  
Chandru P. Sundaram ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Renal Mass ◽  
Laparoscopic Partial Nephrectomy ◽  
University Experience ◽  
Washington University

scholarly journals Comparison of Video-Assisted Minilaparotomy, Open, and Laparoscopic Partial Nephrectomy for Renal Masses

2012 ◽  
Vol 53 (1) ◽  
pp. 151 ◽  
Author(s):  
Hwang Gyun Jeon ◽  
Kyung Hwa Choi ◽  
Kwang Hyun Kim ◽  
Koon Ho Rha ◽  
Seung Choul Yang ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Masses ◽  
Video Assisted

580 RADIOLOGICAL PREDICTION OF PRESERVED RENAL MASS IN PATIENTS UNDERGOING LAPAROSCOPIC PARTIAL NEPHRECTOMY CORRELATION WITH OPERATIVE AND FUNCTIONAL OUTCOMES

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Scott Leslie ◽  
Syed Rahmanuddin ◽  
Eric Yi-Hsiu Huang ◽  
Dennis J. Lee ◽  
Andre Luis de Castro Abreu ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Functional Outcomes ◽  
Renal Mass ◽  
Laparoscopic Partial Nephrectomy

scholarly journals Retroperitoneal Robot-Assisted Laparoscopic Partial Nephrectomy for Horseshoe Kidney: A Case Report

2021 ◽  
Author(s):  
Dongxu Zhang ◽  
Youyi Lu ◽  
Fengze Sun ◽  
Di Wang ◽  
Xingjun Bao ◽  
...  
Keyword(s):  
Case Report ◽  
Partial Nephrectomy ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Horseshoe Kidney ◽  
Laparoscopic Partial Nephrectomy ◽  
Robot Assisted ◽  
3D Reconstructions ◽  
Case Presentations ◽  
The Right

Abstract Background: Horseshoe kidney (HSK) have always been a challenge for urologists depending on its particular anatomy. We report a case of renal tumor in a patient with HSK, who underwent tumor resection by retroperitoneal robot-assisted laparoscopic partial nephrectomy. Case Presentations: A 47-year-old man presented to our hospital with a solid renal mass. Computed tomography urography (CTU) showed a 4.3 × 4.4 cm mass in the upper pole of the right kidney. Patients received a retroperitoneal robot-assisted laparoscopic partial nephrectomy on basis of three-dimensional (3D) reconstructions.Conclusion: The present case report highlights the feasibility of robot-assisted laparoscopic partial nephrectomy for horseshoe kidney, and the advantages of preoperative 3D reconstructions.

scholarly journals Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors: an empirical analysis of 290 patients

2020 ◽  
Author(s):  
Feiya Yang ◽  
Lianjie Mou ◽  
Nianzeng Xing
Keyword(s):  
Partial Nephrectomy ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Intraoperative Ultrasound ◽  
Operation Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Significant Difference ◽  
Group A

Abstract Objective To explore the feasibility of laparoscopic partial nephrectomy(LPN) in the treatment of renal hilar tumors. Methods Clinical data of 290 patients undergoing laparoscopic partial nephrectomy from January 2013 to August 2019 were retrospectively analyzed, including 27 patients with renal hilar tumors and 263 patients with non-hilar renal tumors. Perioperative data and follow-up results were compared between the two groups. Results Tumor size in Group A is smaller(2.97±0.88 vs 3.55±1.46,p<0.05), R.E.N.A.L. nephrometry score of Group A is higher(8.4±1.3 vs 6.5±1.7,p<0.01).The operation time, WIT and intraoperative blood loss in the Group A were slightly higher, but with no statistical difference (p>0.05). There was no significant difference between the two groups in intraoperative ultrasound rate, collection system repair rate, drainage time,postoperative hospital stay, and eGFR changes (p>0.05).The median follow-up period was 40 months. One patient with postoperative pathologic report of angiomyolipoma was found tumor recurrence and was currently undergoing regular reexamination. Conclusion Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors is safe and feasible after detailed preoperative evaluation of the tumor and selection of appropriate surgical strategies.

scholarly journals V7-11 ROBOTIC-ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR A RENAL MASS IN A TWO-YEAR-OLD

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Ramsey Al-Khalil ◽  
Wai Lee ◽  
April Adams Szafran ◽  
Wayne Waltzer ◽  
Ezekiel Young
Keyword(s):  
Partial Nephrectomy ◽  
Renal Mass ◽  
Laparoscopic Partial Nephrectomy ◽  
Robotic Assisted

scholarly journals Safety and efficacy of retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy for low nephrometry score masses

2019 ◽  
Vol 91 (3) ◽  
Author(s):  
Emanuele Corongiu ◽  
Pietro Grande ◽  
Angelo Di Santo ◽  
Giorgio Pagliarella ◽  
Stefano Squillacciotti ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Intraoperative Complications ◽  
Functional Results ◽  
Laparoscopic Partial Nephrectomy ◽  
Tumor Diameter ◽  
Selective Embolization ◽  
Renal Masses ◽  
Nephrometry Score ◽  
Estimated Blood Loss ◽  
Zero Ischemia

Objectives: To evaluate oncological feasibility and oncological and functional results of retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy (LPN). Patients and methods: Patients with posterior renal masses with low nephrometry score (RENAL ≤ 7) treated who underwent retroperitoneal sutureless zero ischemia.in a single center from January 2016 to November 2017. Clinical, surgical and pathological data were prospectively collected. Complications were reported according to the modified Clavien classification. Results: Retroperitoneal sutureless zero ischemia laparoscopic partial nephrectomy was performed on 15 patients. The indication for nephron-sparing surgery was elective in 11 (73%) patients and imperative in 4 (27%). Median RENAL score was 5 (IQR: 5-7), median tumor diameter 25 mm (IQR: 20-35). In 11 cases, the tumor was located polar (85%), and in 2 cases hilar (15%). There were no intraoperative complications. No cases were converted to radical nephrectomy, and in no case parenchyma suture was necessary. Median operative time was 90 min (IQR:40-150), in no case clamping of the renal artery was necessary, median hospital stay was 4 days, median estimated blood loss (EBL) was 310 (180-500) ml. Pathological analysis showed renal cell carcinoma in 11 patients (85%), 9 (60%) staged T1a and 2 (13%) T1b. In 4 (27%) an oncocytoma was found. There were no positive surgical margins. One patient developed a major postoperative complication (postoperative renal bleeding requiring super-selective embolization). Trifecta rate was 93%. Conclusions: Sutureless retroperitoneal zero ischemia LPN for the treatment of low-complexity posterior renal masses showed to be safe and feasible. Longer follow-up and higher numbers of patients are, however, warranted to draw definitive conclusions on functional outcomes.

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