What Type Of Nephrectomy Is Done By Robotics

Robotic nephrectomy for the treatment of benign and malignant disease. 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.

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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.


Video advice: What is a robotic partial nephrectomy?

The goal of partial robotic nephrectomy is to preserve as much of the kidney as possible. In this video, Dr. Joel Lilly describes the steps in this procedure, which is done to remove a tumor from a kidney in patients with kidney cancer. For more information, please visit the Swedish Robotic Surgery Program at:


Robotic nephrectomy on the rise, but why?

The advantages that robotic technologies bring to prostate procedures, partial nephrectomies, and other surgeries that can involve complex reconstruction are not readily apparent in simple extirpative surgeries such as radical nephrectomy. This raises two questions: Are robots being used in radical nephrectomies and if so, why? New Orleans-The advantages that robotic technologies bring to prostate procedures, partial nephrectomies, and other surgeries that can involve complex reconstruction are not readily apparent in simple extirpative surgeries such as radical nephrectomy. This raises two questions: Are robots being used in radical nephrectomies and if so, why? The answer to the first question is “yes, increasingly,” according to a study from the Columbia University Medical Center, New York. The reasons underlying this response are not readily apparent and require some thought and elaboration. “Are there significant advantages to using robots in a purely extirpative procedure such as a radical nephrectomy?

Robot-assisted laparoscopic and open live-donor nephrectomy: a comparison of donor morbidity and early renal allograft outcomes

Abstract. Background. Robot-assisted laparoscopic donor (RALD) nephrectomy, a new procedure for the removal of a kidney from a living donor, was performed on 13.

Data are presented because the mean±SD. Statistically significant variations between your OPEN and RALD groups were analysed through the use of the chi-square or Student’s t-test for parametric data and also the Mann–Whitney rank sum test for non-parametric data, having a P-worth of . 05 considered significant. Results.

  1. Kidney donors and recipients
  2. Pre-operative donor evaluation
  3. Surgical techniques
  4. Recipient evaluation and transplantation
  5. Patient parameters
  6. Statistical analysis
  7. Patient demographics
  8. Intra-operative complications in donors
  9. Post-operative courses for live donors

Material and methods

Background. Robot-assisted laparoscopic donor (RALD) nephrectomy, a new procedure for the removal of a kidney from a living donor, was performed on 13 subjects at our centre. Methods. The immediate post-operative courses for these donors, and their respective recipients, were compared with those of 13 previous open live-donor nephrectomies (OPEN), performed in our facility. Results. We found no significant differences between these two donor groups with respect to age, gender, body mass index or renal vasculature. The average operative times and the warm ischaemia times were greater in the RALD group, 185. 5″ vs 113. 4″ (P = 0. 0001) and 7′15″ vs 1′41″ (P = 0. 0001), respectively. There was no conversion to the open procedure in the RALD group. The estimated blood loss was slight in both groups. Following nephrectomy, deep venous thrombosis occurred in one RALD patient and acute pyelonephritis in one OPEN patient. The average duration of hospitalization was shorter after the RALD procedure (5.

Outcomes and Costs of Robotic-Assisted vs Laparoscopic Radical Nephrectomy

This cohort study uses commercially available health care improvement database data to compare trends in the use, outcomes, and costs of robotic-assisted vs laparoscopic nephrectomy in the United States between 2022 and 2022.

David Jayne, MD Alessio Pigazzi, PhD Helen Marshall, MSc Julie Croft, BSc Neil Corrigan, MSc Joanne Copeland, BSc Phil Quirke, FMedSci Nick West, PhD Tero Rautio, PhD Niels Thomassen, MD Henry Tilney, MD Mark Gudgeon, MS Paolo Pietro Bianchi, MD Richard Edlin, PhD Claire Hulme, PhD Julia Brown, MSc.

Association of Robotic-Assisted vs Laparoscopic Radical Nephrectomy With Perioperative Outcomes and Health Care Costs, 2022 to 2015

Among 23 753 patients included in the study (mean age, 61. 4 years; men, 13 792 (58. 1%)), 18 573 underwent laparoscopic radical nephrectomy and 5180 underwent robotic-assisted radical nephrectomy. Use of robotic-assisted surgery increased from 1. 5% (39 of 2676 radical nephrectomy procedures in 2003) to 27. 0% (862 of 3194 radical nephrectomy procedures) in 2015 (P for trend<. 001). In the weighted-adjusted analysis, there were no significant differences between robotic-assisted and laparoscopic radical nephrectomy in the incidence of any (Clavien grades 1-5) postoperative complications (adjusted rates, 22. 2% vs 23. 4%, difference, −1. 2%; 95% CI, −5. 4 to 3. 0%) or major (Clavien grades 3-5) complications (adjusted rates, 3. 5% vs 3. 8%, difference, −0. 3%; 95% CI, −1. 0% to 0. 5%). The rate of prolonged operating time (>4 hours) for patients undergoing the robotic-assisted procedure was higher than for patients receiving the laparoscopic procedure in the adjusted analysis (46. 3% vs 25. 8%; risk difference, 20.

Robotic Radical Nephrectomy (Partial or Radical) Loyola Medicine, Maywood, IL – Overview What to Expect Side Effects Risks Overview of Robotic Radical Nephrectomy A nephrectomy is a surgical procedure that removes all or part of your.

Loyola is widely recognized as one of the top urology programs nationwide. Our multidisciplinary urologic cancer team is well versed in the recent advances in diagnosis, surgical procedures and treatment options that will allow many patients with kidney cancer to live with the disease and maintain normal schedules and lifestyles.

Nephrectomy

A robot assisted laparoscopic partial nephrectomy is a kidney-sparing procedure in which only the diseased section of the kidney is removed.

A robotic aided laparoscopic partial nephrectomy is really a non-invasive procedure by which several small incisions come in the patient’s abdominal region to provide use of robotically controlled surgical instruments. This surgery differs from a radical nephrectomy where the entire kidney is taken away.

As with any surgery, infections may occur. If you are experiencing infection related symptoms, such as fever, ongoing pain, tenderness, or burning at the incision site(s), contact our office as soon as possible. In addition, notify the surgeon if you experience severe nausea, vomiting, or the inability to urinate (urinary retention). Finally, if the patient has on-going or large amounts of blood in their urine, they should also contact our office.

Robotic Partial Nephrectomy with the Da Vinci Xi

iPurpose./i The surgical expertise to perform robotic partial nephrectomy is heavily dependent on technology. The Da Vinci Xi (XI) is the latest robotic surgical platform with significant advancements compared to its predecessor. We describe our operative technique and experience with the XI system for robotic partial nephrectomy (RPN).i Materials and Methods./i Patients with clinical T1 renal masses were offered RPN with the XI. We used laser targeting, autopositioning, and a novel “in-line” port placement to perform RPN.i Results./i 15 patients underwent RPN with the XI. There were no intraoperative complications and no operative conversions. Mean console time was 101.3 minutes (range 44–176 minutes). Mean ischemia time was 17.5 minutes and estimated blood loss was 120 mLs. 12 of 15 patients had renal cell carcinoma. Two patients had oncocytoma and one had benign cystic disease. All patients had negative surgical margins and pathologic T1 disease. Two postoperative complications were encountered, including one patient who developed a pseudoaneurysm and one readmitted for presumed urinary tract infection.i Conclusions./i RPN with the XI system can be safely performed. Combining our surgical technique with the technological advancements on the XI offers patients acceptable pathologic and perioperative outcomes.

  1. Introduction
  2. Materials and Methods
  3. Results
  4. Discussion
  5. Conclusions
  6. Conflict of Interests
  7. Copyright

Purpose. The surgical expertise to perform robotic partial nephrectomy is heavily dependent on technology. The Da Vinci Xi (XI) is the latest robotic surgical platform with significant advancements compared to its predecessor. We describe our operative technique and experience with the XI system for robotic partial nephrectomy (RPN). Materials and Methods. Patients with clinical T1 renal masses were offered RPN with the XI. We used laser targeting, autopositioning, and a novel “in-line” port placement to perform RPN. Results. 15 patients underwent RPN with the XI. There were no intraoperative complications and no operative conversions. Mean console time was 101. 3 minutes (range 44–176 minutes). Mean ischemia time was 17. 5 minutes and estimated blood loss was 120 mLs. 12 of 15 patients had renal cell carcinoma. Two patients had oncocytoma and one had benign cystic disease. All patients had negative surgical margins and pathologic T1 disease. Two postoperative complications were encountered, including one patient who developed a pseudoaneurysm and one readmitted for presumed urinary tract infection.


Video advice: Robotic Left Radical Nephrectomy

Nephrectomy is the surgical removal of a kidney.


Robotic Surgery for Kidney Cancer NYC

Mount Sinai are utilizes minimally invasive robotic surgery to safely and more precisely remove kidney cancer.

Associated with pension transfer automatic-aided procedures, there’s typically much less discomfort compared to open procedure, less bloodstream loss (and for that reason less requirement for a bloodstream transfusion), less scarring (both inwardly and outwardly), a shorter stay in hospital (one to two days versus up to and including week), along with a shorter overall time to recover before coming back to normalcy activities.

Benefits

At Mount Sinai Urology, our experience with robotic kidney cancer and reconstructive surgery is extensive. Our robotic partial nephrectomy approach allows for a precise excision of the tumor while leaving the healthy and functional part of the kidney intact. In addition, minimally invasive robotic surgery offers fewer complications and side effects, smaller incisions, less scarring, decreased post-surgical pain, shorter hospital stays, and faster recovery.

Robotic partial nephrectomy

Read more about robotic partial nephrectomy for kidney cancer, including the advantages, how the procedure is performed, and open radical nephrectomy.

Robotic/Laparoscopic Partial Nephrectomy for Kidney Cancer

Stanford surgeons are using cutting-edge technology to perform robotic partial nephrectomy, a delicate procedure used to treat kidney cancer. The robot allows the surgeon to have a three-dimensional (3-D) view of the surgical field, at a greatly increased magnification, up to 15 times greater than the human eye. Fine articulating instruments, under the command of the surgeon, are used to precisely remove the tumor alone and preserve the remaining kidney. The surgery can be performed using very small incisions, greatly decreasing recovery time, reducing pain and minimizing scarring. This allows for patients to return to their daily lives with a minimum of inconvenience, despite having undergone major surgery.

Nephrectomy (kidney removal) – Complete (radical) nephrectomy is surgery to remove all of a kidney. Kidney-sparing surgery (partial nephrectomy) removes part of a kidney.

Laparoscopic surgery. In this minimally invasive procedure, the surgeon makes a few small incisions in your abdomen to insert wandlike devices equipped with video cameras and small surgical tools. The surgeon must make a slightly larger opening if your entire kidney needs to be removed.

  1. Kidney function
  2. Cancer treatment
  3. Treatment for other conditions
  4. Planning your hospital stay
  5. Preparing for the surgery
  6. During the procedure
  7. After the procedure
  8. Monitoring kidney function
  9. Taking care of your remaining kidney

Robotic radical nephrectomy for renal cell carcinoma: a systematic review

Laparoscopic radical nephrectomy (LRN) is the actual gold-standard for the treatment of clinically localized renal cell carcinoma (RCC) (cT1-2 with no indications for nephron-sparing surgery). Limited evidence is currently available on the role of robotics in the field of radical nephrectomy. The aim of the current study was to provide a systematic review of the current evidence on the role of robotic radical nephrectomy (RRN) and to analyze the comparative studies between RRN and open nephrectomy (ON)/LRN. A Medline search was performed between 2022–2022 with the terms “robotic radical nephrectomy”, “robot-assisted laparoscopic nephrectomy”, “radical nephrectomy”. Six RRN case-series and four comparative studies between RRN and (ON)/pure or hand-assisted LRN were identified. Current literature produces a low level of evidence for RRN in the treatment of RCC, with only one prospective study available. Mean operative time (OT) ranges between 127.8-345 min, mean estimated blood loss (EBL) ranges between 100–273.6 ml, and mean hospital stay (HS) ranges between 1.2-4.3 days. The comparison between RRN and LRN showed no differences in the evaluated outcomes except for a longer OT for RRN as evidenced in two studies. Significantly higher direct costs and costs of the disposable instruments were also observed for RRN. The comparison between RRN and ON showed that ON is characterized by shorter OT but higher EBL, higher need of postoperative analgesics and longer HS. No advantage of robotics over standard laparoscopy for the treatment of clinically localized RCC was evidenced. Promising preliminary results on oncologic efficacy of RRN have been published on the T3a-b disease. Fields of wider application of robotics should be researched where indications for open surgery still persist.

23.

Abstract

AbstractBackgroundLaparoscopic radical nephrectomy (LRN) is the actual gold-standard for the treatment of clinically localized renal cell carcinoma (RCC) (cT1-2 with no indications for nephron-sparing surgery). Limited evidence is currently available on the role of robotics in the field of radical nephrectomy. The aim of the current study was to provide a systematic review of the current evidence on the role of robotic radical nephrectomy (RRN) and to analyze the comparative studies between RRN and open nephrectomy (ON)/LRN. MethodsA Medline search was performed between 2000–2013 with the terms “robotic radical nephrectomy”, “robot-assisted laparoscopic nephrectomy”, “radical nephrectomy”. Six RRN case-series and four comparative studies between RRN and (ON)/pure or hand-assisted LRN were identified. ResultsCurrent literature produces a low level of evidence for RRN in the treatment of RCC, with only one prospective study available. Mean operative time (OT) ranges between 127. 8-345 min, mean estimated blood loss (EBL) ranges between 100–273.

Partial nephrectomy is a surgical procedure performed on the kidneys. It is usually performed to remove a tumor from the kidney. These tumors can be both cancerous and noncancerous (benign). A nephrectomy may be also needed due to other kidney diseases.

Frequently Asked QuestionsWho is the ideal Partial Nephrectomy patient? First and foremost, the tumor must be in a location that would make a Partial Nephrectomy feasible and safeExperienced surgeons specializing in Partial Nephrectomy have the best chance at removing difficult tumors successfullyWho potentially benefits the most from Partial Nephrectomy? A patient who already suffers from kidney failure. If this patient loses a kidney, he/she are more likely to require dialysis—which will result in a worsened quality (and potentially quantity) of life. A patient who has tumors in both kidneys. Saving one or both kidneys will help this patient avoid kidney failure as well. A patient who has risk factors for kidney failure. The most common reasons patients have poor kidney function today are diabetes and high blood pressure. Having these conditions means you may already have worse kidney function than you think. Saving the kidney will maintain a better kidney function and prevent kidney failure in the future.

Learn how urologic surgeons at Brigham and Women’s Hospital perform a variety of robotic surgery procedures including a robotic partial nephrectomy for kidney cancer removal.

A partial nephrectomy is the partial removal of a kidney tumor while leaving the healthy part of the kidney. The remaining renal function is maximized by only removing the cancerous lesion (instead of the entire kidney), which has been shown to decrease rates of cardiovascular complications in the future.

What are the benefits of a robotic nephrectomy?

Unlike traditional open partial nephrectomy, which requires a 6 to 8-inch long incision in the abdomen or side, only four tiny incisions in the abdomen (see image below) are required for the slender robotic arms and tiny surgical tools used in a robot-assisted partial nephrectomy and other robotic urologic procedures. There are four available arms – one equipped with a high definition 3-D magnification camera, two that act as the surgeon’s arms and a fourth arm that is used for holding back tissue. The camera gives the surgeon enhanced detail, true depth of field and a panoramic view, and the robotic hands’ broad range of movement enables greater dexterity. The surgeon remotely guides the robotic arms while seated at the console, located a short distance away from the patient.

Surgery for Kidney Cancer

Surgery involves removing the entire tumor in the safest manner for each patient, and can be performed through a variety of approaches.

Radical nephrectomy describes elimination of the whole kidney and also the tumor inside the kidney. Radical nephrectomy is conducted with an open cut, laparoscopically or with robot-aided laparoscopic technologies. While elimination of a kidney can impact overall kidney function, most sufferers with two healthy kidneys won’t develop finish-stage kidney disease or require dialysis after nephrectomy.

Surgery for Patients with Metastatic Kidney Cancer (Cytoreductive Nephrectomy)

Partial nephrectomy is also referred to as nephron-sparing surgery or kidney-sparing surgery. During partial nephrectomy, the surgeon removes the tumor and spares the remainder of the kidney. Partial nephrectomy can be performed through an open incision or robotic-assisted laparoscopic surgery — most partial nephrectomies at Johns Hopkins are performed robotically. Partial nephrectomy offers the benefits of sparing the kidney and saving kidney function; however, it can be associated with higher risks of complications, including bleeding or urine leak.

Robotic Surgery for Kidney Cancer

Temple’s urologists offer robotic surgery for kidney cancer, including robotic-assisted partial and total (radical) nephrectomy.

While using robot, we are able to complete lymph node dissections that could match or exceed what best open surgeons can offer. In case your urologist informs you that you’re not an applicant for any non-invasive approach or perhaps a kidney-sparing approach, an appointment having a Temple automatic surgeon is extremely suggested.

Ready for an Appointment?

At Temple, the majority of kidney tumors, masses or complex cysts can be treated with a procedure called partial nephrectomy. This is the surgical removal of the cancerous section of the kidney. In this procedure, a very minimal portion of the normal kidney is removed with the tumor. The vast majority of the healthy kidney tissue is spared and surgically repaired so blood and urine can flow normally. This is sometimes called “nephron-sparing” or “kidney-sparing” surgery.


Video advice: Robot-Assisted Partial Nephrectomy (RAPN)

This animation shows how a Robot-Assisted Partial Nephrectomy procedure is performed.


[FAQ]

What is robotic partial nephrectomy?

Robotic partial nephrectomy utilizes an operating telescope and thin, specialized instruments placed in the abdomen through 3-4 "keyhole" incisions, each 1cm. The blood supply to the kidney is temporarily interrupted to allow for tumor removal without excessive bleeding.

How long is a robotic partial nephrectomy?

Laparoscopic and robotic partial nephrectomy requires that patients undergo a general anesthesia. While operative time varies from one individual to another, the average operating time is approximately 3-4 hours.

Can a nephrectomy be done laparoscopically?

The urologic surgeon may perform a nephrectomy through a single incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen using a camera and small instruments (laparoscopic nephrectomy). In some cases, these laparoscopic procedures are performed using a robotic system.

Is robotic kidney surgery painful?

Both can be very painful. Robotic surgery involves a few small “keyhole” incisions to insert the robotic surgical instruments and a camera. This minimally invasive approach offers several other benefits, including: Smaller incisions, which means less scaring and faster healing.

How long does it take to recover from robotic kidney surgery?

It usually takes half as long to recover from robotic kidney surgery as from an open procedure. You can typically return to work one to four weeks later, depending on how physically demanding your job is. Most people go back to work and normal activities within three weeks of the procedure.

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