scholarly journals Total robotic surgical volume influences outcomes of low-volume robotic-assisted partial nephrectomy over an extended duration

2021 ◽  
Vol 15 (9) ◽  
Author(s):  
Saad Aldousari ◽  
Said Yaiesh ◽  
Omar Alkandari
Keyword(s):  
Partial Nephrectomy ◽  
Operative Time ◽  
Fellowship Training ◽  
Perioperative Outcomes ◽  
Robotic Assisted ◽  
Tertiary Center ◽  
Surgeon Experience ◽  
Extended Duration ◽  
Low Volume ◽  
Robotic Assisted Partial Nephrectomy

Introduction: The objective of this study was to examine the surgeon’s experience of low-volume robotic-assisted partial nephrectomy (RAPN) over an extended duration, and whether a high-volume fellowship-training influenced the outcomes. Methods: Data on all RAPN at a tertiary center performed by a uro-oncologist were retrospectively collected. The surgeon experience was assessed by examining perioperative outcomes among three groups of consecutive patients (first=14, second=14, third=15 patients, respectively). Results: Between February 2014 and February 2020, 45 RAPNs were performed out of a total of 200 robotic procedures. The median tumor size was 3 cm, and 28 (65%) patients had a R.E.N.A.L nephrometry score (RNS) ≥7. The median operative time and warm ischemia time (WIT) were 190 and 16 minutes, respectively. The median estimated blood loss (EBL) was 100 mL. Two (4%) patients had a positive surgical margin (PSM). Overall, five (12%) complications were recorded. All except one were minor (Clavien I–II). The median followup was 26.2 months. Trifecta and pentafecta were achieved in 40 (93%) and 27 (81.8%) patients, respectively. Increased surgeon experience was significantly associated with a shorter operative time and less EBL. Furthermore, there was an independent association between surgeon experience and operative time and EBL, and between RNS and operative time and WIT. Conclusions: With fellowship training and subsequent adequate total number of robotic procedures during practice, it is possible to perform RAPN with favorable perioperative outcomes in the setting of low-volume of cases over an extended duration.

Perioperative Outcomes of Robotic-assisted Partial Nephrectomy in Elderly Patients: A Matched-cohort Study

Urology ◽  
2012 ◽  
Vol 79 (5) ◽  
pp. 1063-1067 ◽  
Author(s):  
Shahab P. Hillyer ◽  
Riccardo Autorino ◽  
Gregory Spana ◽  
Julien Guillotreau ◽  
Robert J. Stein ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Partial Nephrectomy ◽  
Perioperative Outcomes ◽  
Matched Cohort ◽  
Robotic Assisted ◽  
Matched Cohort Study ◽  
Robotic Assisted Partial Nephrectomy

scholarly journals Comparison of Trifecta Outcome Among Open, Laparoscopic, and Robotic-Assisted Partial Nephrectomy in Patients With Small Renal Masses: 10-Year Experience in Ramathibodi Hospital

2021 ◽  
Author(s):  
Chaichant Soisrithong ◽  
Wit Viseshsindh ◽  
Wisoot Kongchareonsombat ◽  
Charoen Leenanupunth ◽  
Wachira Kochakarn ◽  
...  
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Intraoperative Complication ◽  
Robotic Assisted ◽  
Estimated Blood Loss ◽  
Number Of Patients ◽  
Robotic Assisted Partial Nephrectomy

Abstract Purpose: To compare the trifecta outcome and perioperative and postoperative outcomes among open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), and robotic-assisted partial nephrectomy (RAPN) in patients with small renal masses in Ramathibodi Hospital.Methods: We retrospectively reviewed 141 patients who underwent partial nephrectomy from January 2009 to December 2018. The baseline characteristics and preoperative outcomes were compared among the three surgical approaches. Results: Among the 141 patients, 42 (29.79%), 29 (20.57%), and 70 (49.64%) patients underwent OPN, LPN, and RAPN, respectively. Among 116 patients with available data, 71 achieved the trifecta outcome [18 (56.25%), 14 (56.00%), and 39 (73.58%) in the OPN, LPN, and RAPN group, respectively; p=0.276]. The rate of conversion to OPN was higher in the LPN than RAPN group. The number of patients who received intraoperative packed red cells was lowest in the RAPN group. The estimated blood loss was significantly lower in the LPN group than OPN and RAPN groups (p=0.041). The operative time was shorter in the OPN group than LPN and RAPN groups (p<0.001). Multivariate analysis showed that the intraoperative complication rate was a predictive factor for trifecta outcome achievement.Conclusion: OPN had the shortest operative time. LPN had the highest rate of conversion to OPN and lowest estimated blood loss. The number of patients who received intraoperative packed red cells was lowest in the RAPN group. However, achievement of the trifecta outcome was not significantly different among the three groups. The predictive factor for trifecta outcome achievement was the intraoperative complication rate.

Prospective Evaluation of the Association of Adherent Perinephric Fat With Perioperative Outcomes of Robotic-assisted Partial Nephrectomy

Urology ◽  
2015 ◽  
Vol 85 (4) ◽  
pp. 836-842 ◽  
Author(s):  
Andrew J. Davidiuk ◽  
Alexander S. Parker ◽  
Colleen S. Thomas ◽  
Michael G. Heckman ◽  
Kaitlynn Custer ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Perioperative Outcomes ◽  
Prospective Evaluation ◽  
Robotic Assisted ◽  
Robotic Assisted Partial Nephrectomy ◽  
Perinephric Fat
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