TumorsRadical nephrectomyLaparoscopic partialMinimally invasiveCold IschemiaOutcomesTumorPerioperativeIntraoperativeComplicationsRenal functionTimeChronic2019CancerFindingsRobot-assistedUrologicPreservationSurvivalPatientsRobotic approachArterialPostoperativeSurgeryMarginsSurgicalFactorsImagingBlood lossPatientMedicineManagementSingle
Tumors11
- Introduction: Intrarenal tumors pose a unique challenge to surgeons due to the lack of visual cues on the kidney surface. (johnshopkins.edu)
- Intraoperative ultrasonography has facilitated the management of these tumors during minimally invasive partial nephrectomy. (johnshopkins.edu)
- We sought to evaluate the safety, feasibility, and comparative effectiveness of robot-Assisted partial nephrectomy (RPN) in the management of completely intrarenal tumors. (johnshopkins.edu)
- Conclusions: RPN is feasible, safe, and effective in the treatment of select intrarenal kidney tumors with outcomes similar to those of partially exophytic tumors. (johnshopkins.edu)
- Completely intrarenal kidney tumors should not be automatically relegated to radical nephrectomy or open surgery. (johnshopkins.edu)
- Source: Washington University Website "Robotic surgery is more efficient and precise than either open or laparoscopic surgery for tumors confined to the kidney," says Bhayani, assistant professor of surgery and a leader in the field of robotic surgery. (theroboticsurgeon.com)
- Patients with a solitary kidney or multifocal tumors were excluded. (elsevierpure.com)
- Does nephrometry scoring of renal tumors predict outcomes in patients selected for robot-assisted partial nephrectomy? (wakehealth.edu)
- Robotic and laparoscopic partial nephrectomy for T1b tumors. (wakehealth.edu)
- The adoption of robotic assistance has contributed to the increased utilization of partial nephrectomy for the management of renal tumors. (biomedcentral.com)
- Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. (ac.ir)
Radical nephrectomy7
- A prospective comparison of laparoscopic and robotic radical nephrectomy for T1-2N0M0 renal cell carcinoma. (wakehealth.edu)
- A single institution experience of 141 cases of laparoscopic radical nephrectomy with cost-reductive measures. (wakehealth.edu)
- Oncologic outcome of 132 cases of laparoscopic radical nephrectomy with intact specimen removal for T1-2N0M0 renal cell carcinoma. (wakehealth.edu)
- Does Sarcopenia Impact Complications and Overall Survival in Patients Undergoing Radical Nephrectomy for Stage III and IV Kidney Cancer? (wakehealth.edu)
- Comparative Analysis of Renal Functional Outcomes and Overall Survival of Elderly vs Nonelderly Patients Undergoing Radical Nephrectomy. (wakehealth.edu)
- However, partial nephrectomy can be technically challenging because of intraoperative hemorrhage, which limits the ability to identify the tumor margin and may necessitate the conversion to open surgery or radical nephrectomy. (biomedcentral.com)
- During this stressful situation, it is imperative for the surgeon to have an organized approach to management of hemorrhage, as delayed management could lead to prolonged ischemic times, iatrogenic positive surgical margins from inadequate visualization, conversion to open surgery, or radical nephrectomy. (biomedcentral.com)
Laparoscopic partial7
- UroToday - Positive Surgical Parenchymal Margin After Laparoscopic Partial Nephrectomy for Renal Cella: Oncological Outcomes Carcinom Thursday, 15 March 2007 BERKELEY, CA (UroToday.com) - Positive margins following supposedly curative surgery can be devastating for patient and surgeon alike. (theroboticsurgeon.com)
- This study aimed to document the surgical and oncologic results of nephron sparing of non-ischemic laparoscopic partial nephrectomy without the step of hilus controlling and even without dissecting to expose the main renal vascularity and directly focusing on mass removal. (ac.ir)
- The records of the patients who underwent our modified laparoscopic partial nephrectomy technique were evaluated retrospectively. (ac.ir)
- Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. (ac.ir)
- Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy. (ac.ir)
- Touma NJ, Matsumoto ED, Kapoor A. Laparoscopic partial nephrectomy: The Mc Master University experience. (ac.ir)
- 151 . Laparoscopic partial nephrectomy with prior superselective embolisation as treatment for giant renal angiomyolipoma. (ignaciomoncada.com)
Minimally invasive4
- To summarize the available evidence on renorrhaphy techniques and to assess their impact on peri‐operative outcomes after minimally invasive partial nephrectomy (MIPN). (bjuinternational.com)
- Integrated overview of evidence‐based technical principles for renal reconstruction during minimally invasive partial nephrectomy and suggested standardized reporting of key renorrhaphy features in clinical studies on this topic. (bjuinternational.com)
- Traditionally, partial nephrectomy had been performed via an open approach but there has been a steady trend toward a minimally invasive approach [ 2 ]. (biomedcentral.com)
- As partial nephrectomy is increasingly performed with a minimally invasive approach, control of intraoperative hemorrhage can be more challenging than simple manual compression of the renal parenchyma with suturing, as can be done in open surgery. (biomedcentral.com)
Cold Ischemia3
- For SPN, warm ischemia and cold ischemia were used in 72% and 28% of patients, respectively. (elsevierpure.com)
- Intracorporeal cold ischemia was achieved with intra-arterial irrigation of Wisconsin fluid and ice slush hypothermia performed with the use of a laparoscopic specimen bag without extracting the organ from the body. (auanet.org)
- Cold ischemia was 148 minutes. (auanet.org)
Outcomes15
- ObjectiveTo compare the perioperative outcomes of robotic partial nephrectomy (RPN) with laparoscopic PN (LPN) performed for small renal masses (SRMs), in a large multi-institutional series and to define a new composite outcome measure, termed 'optimal outcome' for the RPN group. (wustl.edu)
- Studies providing sufficient details on renorrhaphy techniques during laparoscopic or robot‐assisted partial nephrectomy and comparative studies focused on peri‐operative outcomes were included in qualitative and quantitative analyses, respectively. (bjuinternational.com)
- Comparison of clamping technique in robotic partial nephrectomy: does unclamped partial nephrectomy improve perioperative outcomes and renal function? (wakehealth.edu)
- Does experience in creating a robot-assisted partial nephrectomy (RAPN) programme in an academic centre impact outcomes or complication rate? (wakehealth.edu)
- Do statin medications impact renal functional or oncologic outcomes for robot-assisted partial nephrectomy? (wakehealth.edu)
- Emerging technologies to improve techniques and outcomes of robotic partial nephrectomy: striving toward the pentafecta. (wakehealth.edu)
- Main Renal Artery Clamping With or Without Renal Vein Clamping During Robotic Partial Nephrectomy for Clinical T1 Renal Masses: Perioperative and Long-term Functional Outcomes. (wakehealth.edu)
- Robot-assisted partial nephrectomy: continued refinement of outcomes beyond the initial learning curve. (wakehealth.edu)
- Selective arterial clamping does not improve outcomes in robot-assisted partial nephrectomy: a propensity-score analysis of patients without impaired renal function. (wakehealth.edu)
- Comparison of perioperative and functional outcomes of robotic partial nephrectomy for cT1a vs cT1b renal masses. (wakehealth.edu)
- Reevaluating Warm Ischemia Time as a Predictor of Renal Function Outcomes After Robotic Partial Nephrectomy. (wakehealth.edu)
- Robotic-assisted surgery for partial nephrectomy and cystectomy have a few documented short-term benefits over open or laparoscopic approaches, but the cost effectiveness is unknown, and long-term functional and oncologic outcomes are inadequately studied. (va.gov)
- Most other differences in outcomes probably may be small or non-existent (i.e., complications, lymph node sampling [for cystectomy], warm ischemia time [for partial nephrectomy], etc. (va.gov)
- The first is randomized data for patients undergoing partial nephrectomy, in terms of short-term outcomes. (va.gov)
- The second is high-quality evidence with adequate long-term follow-up to assess cancer outcomes between the operative approaches for either partial nephrectomy or cystectomy. (va.gov)
Tumor7
- Pseudoaneurysms following partial nephrectomies for Wilms' Tumor and renal cell carcinoma. (llu.edu)
- What are my chances that my kidney tumor is benign? (theroboticsurgeon.com)
- Background: Tumor enucleation (TE) optimizes parenchymal preservation and could yield better function than standard partial nephrectomy (SPN), although data on this are conflicting. (elsevierpure.com)
- Patient summary: Tumor enucleation for kidney cancer involves dissection along the tumor capsule and optimally preserves normal kidney tissue, which may lead to better functional recovery. (elsevierpure.com)
- Reducing the risk of hemorrhage during robotic partial nephrectomy begins with reviewing the preoperative imaging for renal vasculature and tumor anatomy, with a focus on accessory vessels and renal tumor proximity to the renal hilum. (biomedcentral.com)
- During partial nephrectomy, in which part of the kidney is removed for a renal tumor, hemorrhage can be particularly troublesome because the kidney is a well perfused organ and renal cell carcinomas are associated with increased vascularity [ 1 ]. (biomedcentral.com)
- Present un-controlled results pointed that tumor-focusing nephron-sparing non-ischemic partial lap-aroscopic nephrectomy may be preferable for small-sized, low-complex renal masses. (ac.ir)
Perioperative1
- The Trifecta was defined as negative surgical margin, zero perioperative complications and a warm ischaemia time of ≤25 min. (wustl.edu)
Intraoperative2
- A treatment safety checklist for the management of hemorrhage during robotic partial nephrectomy was collaboratively developed based on prior experiences with intraoperative hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
- Safely performing robotic partial nephrectomy is dependent on attention to prevention of hemorrhage and rapid response to the challenge of intraoperative bleeding. (biomedcentral.com)
Complications4
- Predictors of Medical and Surgical Complications After Robot-Assisted Partial Nephrectomy: An Analysis of 1139 Patients in a Multi-Institutional Kidney Cancer Database. (wakehealth.edu)
- Predicting Complications Following Robot-Assisted Partial Nephrectomy with the ACS NSQIP® Universal Surgical Risk Calculator. (wakehealth.edu)
- There is a signal that length-of-stay may be shorter and major complications may be fewer for robot-assisted cases of partial nephrectomy, but again the certainty of evidence is low . (va.gov)
- Although kidney transplantation has become a mainstay in the long-term management of many patients with renal failure , the procedure can be associated with complications such as neurologic, immunologic, infectious, vascular, and urologic. (medscape.com)
Renal function1
- Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy. (ac.ir)
Time7
- Specific tumour features (i.e. size, hilar location, anatomical complexity, nearness to renal sinus and/or urinary collecting system), surgeon's experience, robot‐assisted technology, as well as the aim of reducing warm ischaemia time and the amount of devascularized renal parenchyma preserved represented the key factors driving the evolution of the renorrhaphy techniques during MIPN over the past decade. (bjuinternational.com)
- Quantitative synthesis showed that running suture was associated with shorter operating and ischaemia time, and lower postoperative complication and transfusion rates than interrupted suture. (bjuinternational.com)
- Barbed suture had lower operating and ischaemia time and less blood loss than non‐barbed suture. (bjuinternational.com)
- The single‐layer suture technique was associated with shorter operating and ischaemia time than the double‐layer technique. (bjuinternational.com)
- Source: UroToday The mean total operative time (140 vs 156 minutes, P = .04), warm ischemia time (19 vs 25 minutes, P = .03), and length of stay (2.5 vs 2.9 days, P = .03) were significantly shorter for RPN than for LPN, respectively. (theroboticsurgeon.com)
- Warm ischemia time prior to renal cooling was 6 minutes. (auanet.org)
- Since that time, the authors have performed a total of over 1500 robotic partial nephrectomies. (biomedcentral.com)
Chronic3
- The 'optimal outcome' was defined as achievement of Trifecta with addition of 90% estimated glomerular filtration rate preservation and no chronic kidney disease stage upgrading. (wustl.edu)
- The obesity epidemic represents an expanding threat of chronic kidney disease (CKD). (medscape.com)
- Ischemia is not an independent predictive factor of chronic renal failure after partial nephrectomy in a solitary kidney in patients without pre-operative renal insufficiency. (univ-rennes.fr)
20191
- To help clinicians, patients, and policymakers decide between robotic and other surgical approaches in patients undergoing partial nephrectomy and cystectomy, VA's Evidence Synthesis Program (ESP) in West Los Angeles, CA reviewed the literature in PubMed from 1/1/2010 through 6/29/2019 and Cochrane (all databases) from 1/1/2010 through 6/29/2019. (va.gov)
Cancer1
- Source: NPR A researcher has found a potential therapy for patients with kidney cancer, which historically hasn't responded well to other therapies, such as radiation and chemotherapy. (theroboticsurgeon.com)
Findings1
- UroToday - Incidence of Benign Pathologic Findings at Partial Nephrectomy for Solitary Renal Mass Presumed to be Renal Cell Carcinoma on Preoperative Imaging The authors conclude that there is no reliable indicator of benign pathology preoperatively in solitary renal masses, as all of these were considered to be renal cell carcinoma on preoperative imaging. (theroboticsurgeon.com)
Robot-assisted3
- Robot-assisted partial nephrectomy: current status, techniques, and future directions. (wakehealth.edu)
- Robot-assisted surgery probably results in less blood loss than open or laparoscopic approaches, for both partial nephrectomy and cystectomy procedures. (va.gov)
- The data comparing robot-assisted partial nephrectomy and cystectomy to other approaches have underlying methodologic limitations and long-term studies are sparse. (va.gov)
Urologic1
- While the robotic approach has become the standard approach to prostatectomy, there are other urologic procedures (i.e., partial nephrectomy and cystectomy) in which the robotic approach is being introduced. (va.gov)
Preservation1
- Design, setting, and participants: Patients managed with partial nephrectomy (PN) with necessary data for analysis of preservation of ipsilateral parenchymal mass (IPM) and global glomerular filtration rate (GFR) from two centers were included. (elsevierpure.com)
Survival1
- however, for those with ESRD attributed to diabetes, kidney transplantation affords better survival and rehabilitation than either hemodialysis or peritoneal dialysis. (medscape.com)
Patients3
- Indocyanine green cannot predict malignancy in partial nephrectomy: histopathologic correlation with fluorescence pattern in 100 patients. (wakehealth.edu)
- A nonrandomized prospective comparison of robotic-assisted partial nephrectomy in the elderly to a younger cohort: an analysis of 339 patients with intermediate-term follow-up. (wakehealth.edu)
- A Propensity Score-Matched Comparison of Clamp Technique in Patients with Two Kidneys. (wakehealth.edu)
Robotic approach1
- We constructed a method for performing renal autotrasplant via a robotic approach without the necessity of kidney extraction. (auanet.org)
Arterial1
- Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischaemia robotic partial nephrectomy. (wakehealth.edu)
Postoperative1
- [ 1 , 2 ] A sonographic survey of a recently transplanted kidney offers a noninvasive means by which to identify postoperative hemorrhage, urinary leaks, and early signs of posttransplant rejection. (medscape.com)
Surgery3
- This was the first live televised kidney surgery. (theroboticsurgeon.com)
- These were cases with 46, XX congenital adrenal hyperplasia, partial androgen insensitivity, mixed or partial gonadal dysgenesis, and micropenis where data about the assigned gender, childhood genital-normalizing surgery, and adult gender could be extracted. (e-urol-sci.com)
- Laparoscopic surgery of the kidney. (ac.ir)
Margins1
- This review of an article by one of the founders of laparoscopic urology shows that with one of the common laparoscopic method to remove a kidney, ureter, and bladder cuff for transitional cell caner of the upper urinary tract lining there seems to be a higer recurrence rate and positive margins. (theroboticsurgeon.com)
Surgical1
- Although a kidney biopsy may be required in some cases, noninvasive imaging should be attempted first, to identify clinical situations that can be corrected by radiologic or surgical intervention. (medscape.com)
Factors1
- The goal of this manuscript is to educate robotic surgeons in factors to minimize hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
Imaging1
- Does infrared imaging improve partial nephrectomy for renal cell carcinoma? (wakehealth.edu)
Blood loss2
- Series on robotic partial nephrectomy report a reasonable blood loss (Table 1 ). (biomedcentral.com)
- Table 1 Selected reports from 2009-2012 of estimated blood loss during robotic partial nephrectomy with hilar clamping. (biomedcentral.com)
Patient2
- The patient in our report is a 31 year-old man with a history of a malrotated left kidney, recurrent renal stones and resultant hematuria-loin-pain syndrome. (auanet.org)
- Harvesting of the left-sided renal unit was performed with the patient in left-side up modified flank position with robotic ports in similar arrangement to robotic partial nephrectomy. (auanet.org)
Medicine1
- The following is a partial list of the "E" codes for Medical Subject Headings (MeSH), as defined by the United States National Library of Medicine (NLM). (wikipedia.org)
Management2
- To our knowledge, a comprehensive safety checklist does not exist to guide surgeons on the management of hemorrhage during robotic partial nephrectomy. (biomedcentral.com)
- We then developed a safety and management checklist for "hemorrhage while clamped" during robotic partial nephrectomy. (biomedcentral.com)
Single1
- Multicenter experience with nonischemic multiport laparoscopic and laparoendoscopic single-site partial nephrectomy utilizing bipolar radiofrequency ablation coagulator. (ac.ir)