Introduction: During retroperitoneal robot-assisted partial nephrectomy (RAPN), achieving hemostasis, while maintaining optimum renal function continues to be a key challenge.1 The renorrhaphy in retroperitoneal RAPN often results in prolongation of the warm ischemia time (WIT) and pseudoaneurysm formation later.2 A Sutureless approach can minimize the WIT and tissue damage due to ligation of segmental arteries and strangulation of the parenchyma during renorrhaphy. Therefore, various methods like segmental and selective arterial clamping, unclamped RAPN, and different hemostatic patches on the tumor bed are being explored. We routinely perform clamp-free RAPN, specially in the patients with a solitary functioning kidney and post-unilateral nephrectomy. We try not to perform the inner renorrhaphy unless necessary, and we have started using hemostatic patches to bring down the rate of pseudoaneurysm formation later.
Kishore et al. (Thu,) studied this question.