To clamp or not to clamp in robotic partial nephrectomy?

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Off-clamp robotic-assisted partial nephrectomy

BMI of 32.2±8.3kg/m2. The mean clinical tumor size was 2.9±1.6cm with a mean nephrometry score of 6.9±2.1. There was a mean operative time of 169±61 minutes and a mean estimated blood loss of 242±299mL. Positive surgical margins occurred in 2 cases (1.1%). Average hospital length of stay was 2±1.3 days, and there were 14 (7.5%) postoperative complications. Mean percent decline of eGFR was 6.8±2...

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Editorial Comment: Off-clamp Robotic-assisted Partial Nephrectomy

In this video the Wright et al. (1) demonstrate their off-clamp technique of robotic-assisted partial nephrectomy (RAPN) and subsequently report the outcomes of a cohort of patients previously treated utilizing this technique. The method of choice for haemostasis in this video is electrocautery with the compression of larger vessels with robotic fourth arms if troublesome bleeding is encountere...

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Robotic partial nephrectomy with selective parenchymal compression (Simon clamp).

OBJECTIVE To present our initial experience using selective renal parenchymal ischemia, without hilar clamping, in robotic-assisted partial nephrectomy. MATERIAL AND METHODS In four patients with T1a renal tumor we performed robotic-assisted partial nephrectomy, using the Simon's clamp (Aesculap). It provides selective parenchymal compression without the need of vascular clamping. All patient...

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Robot-assisted partial nephrectomy: off-clamp technique.

Robot-assisted partial nephrectomy (RAPN) has been established as a viable alternative to open and laparoscopic partial nephrectomy for small renal tumors. Multiple variations in surgical technique have been described to reduce warm ischemia time (WIT). We present our off-clamp technique for RAPN. From August 2007 to January 2012, off-clamp RAPN was performed on 47 tumors in 39 patients. WIT wa...

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Comparison of off-clamp partial nephrectomy and on-clamp partial nephrectomy: a systematic review and meta-analysis.

OBJECTIVE To compare peri- and postoperative variables, surgical complications, oncological outcomes and renal outcomes of off-clamp partial nephrectomy (PN) and on-clamp PN. METHODS A systematic search of the electronic databases, including MEDLINE, Embase and Cochrane Library, was performed. The pooled estimates of tumour size, operative time, estimated blood loss, length of stay, overall c...

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ژورنال

عنوان ژورنال: BJU International

سال: 2015

ISSN: 1464-4096

DOI: 10.1111/bju.13019