Abstract:Objective: To discuss the clinical results and advantages in robot-assisted laparoscopic partial nephrectomy (RALPN) guided by mixed reality technology for totally intrarenal tumors. Methods: The clinical data of 15 cases of totally intrarenal tumors receiving RALPN from April 2017 to March 2018 in our department were collected and retrospectively analyzed. There were 6 cases of right renal tumors and 9 cases of left renal tumors. Before operation, doctors can define the preoperative plan with 3D digital models, and the holographic model and the robot operation images were fused in real time during the operation for navigation. Results: All the 15 cases were operated successfully and there was no open conversion and large vessel injury. Average operative time was 122 min (67-211 min), and the mean ischemia time was 21 min (15-42 min). The average blood loss was 78 mL (48-480 mL). There were 10 cases of retroperitoneal approach, and 5 cases of abdominal route. Six cases of renal pelvis repair were performed during the operation. Pathologically, there were 13 cases of clear cell renal cell carcinoma, one case of papillary renal cell carcinoma and one case of cystic renal cell carcinoma. No positive surgical margin or urine leakage was observed. All patients had no local recurrence or distant metastasis during a mean follow-up period of 9 months (3-14 months). Conclusions: The application of mixed reality technique combined with robotic surgery system in the treatment of totally intrarenal tumors has obvious advantages in tumor localization and safety. The operation difficulty can be obviously reduced.
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