V14-01 Robotic Management of Renal Tumors: One Access to Rule Them All?

You have accessJournal of UrologyAdrenal/Renal Oncology II (V14)1 May 2024V14-01 ROBOTIC MANAGEMENT OF RENAL TUMORS: ONE ACCESS TO RULE THEM ALL? William B. Fox, Luca Morgantini, Gabriel van de Walle, Juan Torres, and Simone Crivellaro William B. FoxWilliam B. Fox , Luca MorgantiniLuca Morgantini , Gabriel van de WalleGabriel van de Walle , Juan TorresJuan Torres , and Simone CrivellaroSimone Crivellaro View All Author Informationhttps://doi.org/10.1097/01.JU.0001008704.74547.03.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic retroperitoneal access for partial nephrectomies has encountered limited adoption, primarily due to the steep learning curve and the complexity of accessing upper pole and anterior lesions. In response to these challenges, the da Vinci Single Port (SP) Robotic Supine Anterior Retroperitoneal Access (SARA) technique was described, simplifying retroperitoneal access to the upper collecting system. In this series of videos, we demonstrate five partial nephrectomies with enucleation of masses in challenging renal locations. METHODS: Four patients underwent five partial nephrectomies, with one patient having bilateral masses addressed in a staged approach. The renal masses were located on the anterior and posterior surfaces of the upper pole and the posterior surface of the lower pole. Following the standard SARA approach, with a 4-cm incision on the McBurney point and a combination of blunt and sharp dissection, we entered the retroperitoneal space and inserted a small SP access port. This video showcases different dissection pathways used to target lesions on the anterior and posterior surfaces of the kidney. RESULTS: For all five cases, warm ischemia time was less than 30 minutes, and surgical margins were negative for malignancy. All patients were discharged on the same day without complications or requiring narcotic medications. CONCLUSIONS: The SARA technique is a safe alternative for approaching renal masses regardless of anatomical location. The adaptability of one access capable of reaching any upper tract surgical location will increase the surgeon's familiarity with the retroperitoneal approach. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1227 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information William B. Fox More articles by this author Luca Morgantini More articles by this author Gabriel van de Walle More articles by this author Juan Torres More articles by this author Simone Crivellaro More articles by this author Expand All Advertisement PDF downloadLoading ...