Robot-assisted partial nephrectomyLaparoscopic partialRadical nephrectomyRobotic-assisted partial nephrectomyOutcomesTumorsMinimally invasiveLaparoendoscopic single siteComplicationsOperative timeHilarTransfusion ratesIschemicIntraoperativeMinimizeFindingsMETHODSSystematicArterialBlood lossPatientsPaduaKidneySurgeryModerateTechniqueAbstractMinutesCasesClinicalManagement
Robot-assisted partial nephrectomy13
- 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)
- Perioperative outcomes following robot-assisted partial nephrectomy fo" by Gopal Sharma, Milap Shah et al. (henryford.com)
- INTRODUCTION: Outcomes of robot-assisted partial nephrectomy (RAPN) depend on tumor complexity, surgeon experience and patient profile among other variables. (henryford.com)
- The data comparing robot-assisted partial nephrectomy and cystectomy to other approaches have underlying methodologic limitations and long-term studies are sparse. (va.gov)
- 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)
- Robot-assisted partial nephrectomy: current status, techniques, and future directions. (wakehealth.edu)
- Does nephrometry scoring of renal tumors predict outcomes in patients selected for robot-assisted partial nephrectomy? (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)
- 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)
- 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)
- Predicting Complications Following Robot-Assisted Partial Nephrectomy with the ACS NSQIP® Universal Surgical Risk Calculator. (wakehealth.edu)
Laparoscopic partial10
- Robotic and laparoscopic partial nephrectomy for T1b tumors. (wakehealth.edu)
- 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)
- To prospectively compare the surgical and pathological outcomes obtained with robot-assisted laparoscopic partial nephrectomy (RAPN) or laparoscopic PN (LPN) for renal cell carcinoma in a multicentre cohort. (bjuinternational.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)
- With the increasing use of robotics, many centres have reported their early experiences using it for nephron-sparing surgery.Objective: to review published literature comparing robotic partial nephrectomy (RPN) with laparoscopic partial nephrectomy (LPN).Evidence acquisition: an online systematic review of the literature according to Cochrane guidelines was conducted from 2000 to 2012 including studies comparing RPN and LPN. (soton.ac.uk)
- 151 . Laparoscopic partial nephrectomy with prior superselective embolisation as treatment for giant renal angiomyolipoma. (ignaciomoncada.com)
Radical nephrectomy8
- Completely intrarenal kidney tumors should not be automatically relegated to radical nephrectomy or open surgery. (johnshopkins.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)
- 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)
Robotic-assisted partial nephrectomy2
- 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)
- Evaluation of renal function under controlled hypotension in zero ischemia robotic assisted partial nephrectomy. (ac.ir)
Outcomes14
- 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)
- Objective To assess the functional and oncologic outcomes of robotic laparoendoscopic single site surgery (LESS) partial nephrectomy with a minimum of 2-year follow-up. (ewha.ac.kr)
- Conclusion This study appears to be the first to report on intermediate term functional and oncologic outcomes after robotic LESS partial nephrectomy. (ewha.ac.kr)
- 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)
- Multivariate logistic regression was conducted to ascertain predictors of trifecta (absence of complications, negative surgical margins, and warm ischemia times [WIT]ischemia) outcomes. (henryford.com)
- 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)
- Comparison of clamping technique in robotic partial nephrectomy: does unclamped partial nephrectomy improve perioperative outcomes and renal function? (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)
- 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)
Tumors5
- Videos demonstrating robotic partial nephrectomy for two particularly challenging hilar tumors were selected for presentation. (auanet.org)
- Robotic partial nephrectomy is technically feasible for highly complex hilar tumors. (auanet.org)
- Intraoperative ultrasonography has facilitated the management of these tumors during minimally invasive partial nephrectomy. (johnshopkins.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)
Minimally invasive3
- 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)
Laparoendoscopic single site1
- Multicenter experience with nonischemic multiport laparoscopic and laparoendoscopic single-site partial nephrectomy utilizing bipolar radiofrequency ablation coagulator. (ac.ir)
Complications4
- The Trifecta was defined as negative surgical margin, zero perioperative complications and a warm ischaemia time of ≤25 min. (wustl.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)
- Whereas the perioperative complications were Clavien grades I, II, and III (74%, 23%, and 3%, respectively), mean hospital stay and fol-low-up time were 4.05 ± 1.97 and 19.67 ± 13.57 (ranges: 2-10 days and 1-44 months), respectively. (ac.ir)
- There was no difference regarding postoperative length of hospital stay ( p = 0.37), complications ( p = 0.86), or positive margins ( p = 0.93).Conclusions: in early experience, RPN appears to be a feasible and safe alternative to its laparoscopic counterpart with decreased warm ischaemia times noted. (soton.ac.uk)
Operative time3
- The median resected tumor size was 3 cm (2, 3.7), and the median operative time was 185 minutes (135, 237). (ewha.ac.kr)
- The median operative time, WIT, and blood loss were 173 (range 45-546) min, 21 (range 0-55) min, and 150 (range 50-3500) ml, respectively. (henryford.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)
Hilar2
- 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)
- Table 1 Selected reports from 2009-2012 of estimated blood loss during robotic partial nephrectomy with hilar clamping. (biomedcentral.com)
Transfusion rates2
- 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)
- Mean operation time, estimated blood loss, and transfusion rates were 138.62 ± 38.45 minutes (range: 90-240 min), 242.24 ± 107.12 mL (range: 100-500 mL), and 19%, respectively. (ac.ir)
Ischemic2
- Hemorrhage is further concerning as control can occupy valuable time during which the renal unit is ischemic due to renal vascular clamping during tumor excision. (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)
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)
Minimize2
- Induction of hypometabolism as a novel strategy to minimize ischemia reperfusion injury in renal reconstruction surgery. (tourolib.org)
- The goal of this manuscript is to educate robotic surgeons in factors to minimize hemorrhage during robotic partial nephrectomy. (biomedcentral.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)
METHODS1
- Materials and Methods Thirty-nine consecutive patients who had undergone robotic LESS partial nephrectomy were identified with a minimum of 2-year follow-up. (ewha.ac.kr)
Systematic1
- A systematic review of the literature was performed in January 2018 without time restrictions, using MEDLINE, Cochrane and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement recommendations. (bjuinternational.com)
Arterial1
- Near-infrared fluorescence imaging to facilitate super-selective arterial clamping during zero-ischaemia robotic partial nephrectomy. (wakehealth.edu)
Blood loss6
- Barbed suture had lower operating and ischaemia time and less blood loss than non‐barbed suture. (bjuinternational.com)
- The median estimated blood loss was 150 mL (70, 150), and the median warm ischemia time was 25 minutes (17, 35). (ewha.ac.kr)
- Robot-assisted surgery probably results in less blood loss than open or laparoscopic approaches, for both partial nephrectomy and cystectomy procedures. (va.gov)
- Series on robotic partial nephrectomy report a reasonable blood loss (Table 1 ). (biomedcentral.com)
- The operative data included operative duration, warm ischaemia time (WIT) and estimated blood loss (EBL). (bjuinternational.com)
- There was no difference between the two groups regarding operative times ( p = 0.58), estimated blood loss ( p = 0.76), or conversion rates ( p = 0.84). (soton.ac.uk)
Patients5
- Using our retrospective robotic partial nephrectomy database, we abstracted data on patients who were treated between 2006 and 2015. (auanet.org)
- 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)
- 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)
- Indocyanine green cannot predict malignancy in partial nephrectomy: histopathologic correlation with fluorescence pattern in 100 patients. (wakehealth.edu)
- 147 . Effects of tadalafil once daily or on demand versus placebo on time to recovery of erectile function in patients after bilateral nerve-sparing radical prostatectomy. (ignaciomoncada.com)
Padua1
- Serileri birbirleri ile daha sağlıklı kıyaslamak ve öğrenme eğrisini daha objektif analiz edebilmek amacı ile Padua, centrality-index ,nefrometri ve Zero ischemia-index (ZII-Zhongshan index) gibi farklı skorlama-sınıflama sistemleri oluşturulmuştur. (urolojihekimleri.org)
Kidney2
- Partial nephrectomy , also called kidney-sparing, is where only a portion of the kidney is resected. (va.gov)
- 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)
Surgery1
- 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)
Moderate1
- Operating room time in cystectomy was judged to have moderate certainty that robot-assisted procedures take more time. (va.gov)
Technique1
- The single‐layer suture technique was associated with shorter operating and ischaemia time than the double‐layer technique. (bjuinternational.com)
Abstract1
- The abstract is reproduced below and you can click on the button to read the full article, which is freely available to all readers for at least 30 days from the time of this post. (bjuinternational.com)
Minutes1
- Median operative and warm ischemia times were 3.3 hours (IQR, 2.7-4.3) and 26 minutes (IQR, 21-33), respectively. (auanet.org)
Cases1
- Cases assigned female had more than five times greater likelihood of assigned gender incongruence (95% confidence interval = 1.96-14.92). (e-urol-sci.com)
Clinical1
- Studies have demonstrated the clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. (rnpedia.com)
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)