Robotic nephrectomy, ex-vivo nephron-sparing surgery, and robotic renal autotransplantation for the treatment of complex renal masses (One case report)
Wang Xinning2, Zu Qiang1, Zhu Qiang1, Zhang Lei1, Zhou Qiwei1, Fan Yang1, Dong Jun1, Zhang Xu1
1Department of Urology, Chinese PLA General Hospital, Beijing 100853, China
Abstract:Objective: To investigate the feasibility of robot-assisted laparoscopic nephrectomy, ex-vivo hypothermia bench nephron-sparing surgery and robot-assisted laparoscopic renal autotransplantation to treat complex renal masses. Methods: One patient underwent robot-assisted laparoscopic nephrectomy, ex-vivo hypothermia bench nephron-sparing surgery and robot-assisted laparoscopic renal autotransplantation at January 15th, 2018. Results: Total operation time was 7 h 10 min. The warm ischemia time was 1.5 min and the cold ischemia time was 3 h 30 min. The operation time of venous anastomosis was 10 min and the time of artery anastomosis was 11 min. Six left renal masses were resected, and chromophobe renal carcinoma was diagnosed pathologically. The serum creatinine was 96.7 and 87.1 μmol/L at the 9th and 30th day postoperatively. Autograft function showed by CT was normal 1-month after the operation. Conclusions: The robot-assisted laparoscopic renal autotransplantation with ex-vivo hypothermia bench nephron-sparing surgery can be used to treat complex renal mass and further optimization is needed.
[1] Hardy JD.High ureteral injuries. Management by autotransplantation of the kidney. JAMA, 1963,184:97-101.
[2] Azhar B, Patel S, Chadha P, et al.Indications for renal autotransplant: an overview. Exp Clin Transplant, 2015,13(2):109-114.
[3] Gordon ZN, Angell J, Abaza R.Completely intracorporeal robotic renal autotransplantation. J Urol, 2014,192(5):1516-1522.
[4] Araki M, Wada K, Mitsui Y, et al.Robotic renal autotransplantation: first case outside of North America. Acta Med Okayama, 2017,71(4):351-355.
[5] Lee JY, Alzahrani T, Ordon M.Intra-corporeal robotic renal auto-transplantation. Can Urol Assoc J, 2015,9(9/10):E748-E749.
[6] 刘圣圳,董隽,罗光达,等.机器人辅助腹腔镜活体供肾切取术(附2例报告).微创泌尿外科杂志,2015,4(2):75-77.
[7] 那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南(2014版).北京:人民卫生出版社,2013:6-7.
[8] Nayak JG, Koulack J, Mcgregor TB.Laparoscopic nephrectomy, ex vivo partial nephrectomy, and autotransplantation for the treatment of complex renal masses. Case Rep Urol, 2014:354104.
[9] Zheng J, Zhou Z, Chen Z, et al.Bench surgery with renal autotransplantation for angiomyolipoma of renal sinus. Transplant Proc, 2014,46(5):1281-1285.
[10] Mickisch GH.Renal cell cancer: Bench surgery and autotransplantation for complex localised disease. Eur Urol Suppl, 2007,6(8, SI):544-548.
[11] 张晓文,张磊,张光远,等.离体肾部分切除联合自体肾移植术治疗复杂肾肿瘤.南京医科大学学报(自然科学版),2017,37(5):629-631.
[12] Ratner LE, Kavoussi LR, Schulam PG, et al.Comparison of laparoscopic live donor nephrectomy versus the standard open approach. Transplant Proc, 1997,29(1/2):138-139.
[13] 张旭,高江平,符伟军,等.机器人辅助腹腔镜在泌尿外科手术中的临床应用(附500例报告).微创泌尿外科杂志,2014,3(1):4-7.
[14] 孙祯,符伟军,祝强,等.达芬奇机器人手术在泌尿外科的应用.海南医学,2016,27(3):386-388.
[15] Levi Sandri GB, De Werra E, Mascianà G, et al.The use of robotic surgery in abdominal organ transplantation: A literature review. Clin Transplant, 2017,31(1):e12856.
[16] Breda A, Territo A, Gausa L, et al.Robotic kidney transplantation: one year after the beginning. World J Urol, 2017,35(10):1507-1515.
[17] Territo A, Mottrie A, Abaza R, et al.Robotic kidney transplantation: current status and future perspectives. Minerva Urol Nefrol, 2017,69(1):5-13.
[18] Wagenaar S, Nederhoed JH, Hoksbergen AW, et al.Minimally invasive, laparoscopic, and robotic-assisted techniques versus open techniques for kidney transplant recipients: a systematic review. Eur Urol, 2017,72(2):205-217.
[19] Sood A, Ghosh P, Menon M, et al.Robotic renal transplantation: Current status. J Minim Access Surg, 2015,11(1):35-39.
[20] Oberholzer J, Giulianotti P, Danielson KK, et al.Minimally invasive robotic kidney transplantation for obese patients previously denied access to transplantation. American Am J Transplant, 2013,13(3):721-728.
[21] Tzvetanov I, D'amico G, Benedetti E. Robotic-assisted Kidney Transplantation: Our Experience and Literature Review. Curr Transplant Rep, 2015,2(2):122-126.
[22] Meier RPH, Piller V, Hagen ME, et al.Intra-abdominal cooling system limits ischemia-reperfusion injury during robot-assisted renal transplantation. Am J Transplant, 2018,18(1):53-62.
[23] Breda A, Territo A, Gausa L, et al.Robot-assisted kidney transplantation: The European experience. Eur Urol, 2018,73(2):273-281.
[24] Menon M, Sood A, Bhandari M, et al.Robotic kidney transplantation with regional hypothermia: a step-by-step description of the Vattikuti Urology Institute-Medanta technique (IDEAL phase 2a). Eur Urol, 2014,65(5):991-1000.
[25] Menon M, Abaza R, Sood A, et al.Robotic kidney transplantation with regional hypothermia: evolution of a novel procedure utilizing the IDEAL guidelines (IDEAL phase 0 and 1). Eur Urol, 2014,65(5):1001-1009.
[26] Tuğcu V, Şener NC, Şahin S, et al.Robotic kidney transplantation: The Bakırköy experience. Turk J Urol, 2016,42(4):295-298.
[27] Tuğcu V, Şener NC, Şahin S, et al.Robot-assisted kidney transplantation: comparison of the first 40 cases of open vs robot-assisted transplantations by a single surgeon. BJU Int, 2018,121(2):275-280.
[28] Michiels C, Rouffilange J, Comat V, et al.Total preperitoneal Robot-assisted kidney transplantation. J Endourol Case Rep, 2017,3(1):169-172.