Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA.
Int Braz J Urol. 2009 Mar-Apr;35(2):199-203; discussion 203-4. doi: 10.1590/s1677-55382009000200010.
For the treatment of renal tumors, minimally invasive nephron-sparing surgery has become increasingly performed due to proven efficiency and excellent functional and oncological outcomes. The introduction of robotics into urologic laparoscopic surgery has allowed surgeons to perform challenging procedures in a reliable and reproducible manner. We present our surgical technique for robotic assisted partial nephrectomy (RPN) using a 3-arm approach, including a sliding-clip renorrhaphy.
Our RPN technique is presented which describes the trocar positioning, hilar dissection, tumor identification using intraoperative ultrasound for margin determination, selective vascular clamping, tumor resection, and reconstruction using a sliding-clip technique.
RPN using a sliding-clip renorrhaphy is a valid and reproducible surgical technique that reduces the challenge of the procedure by taking advantage of the enhanced visualization and control afforded by the robot. The renorrhaphy described is performed under complete control of the console surgeon, and has demonstrated a reduction in the warm ischemia times in our series.
为了治疗肾肿瘤，由于微创肾部分切除术具有已被证实的效率和良好的功能及肿瘤学结果，因此越来越多地采用这种方法。机器人技术在泌尿外科腹腔镜手术中的引入使外科医生能够以可靠和可重复的方式进行具有挑战性的手术。我们介绍了一种使用 3 臂方法进行机器人辅助部分肾切除术（RPN）的手术技术，包括滑动夹肾缝合。
介绍了我们的 RPN 技术，包括套管针的定位、肾门解剖、术中超声确定边缘、选择性血管夹闭、肿瘤切除以及使用滑动夹技术进行重建。
使用滑动夹肾缝合的 RPN 是一种有效且可重复的手术技术，它利用机器人提供的增强可视化和控制，降低了手术的难度。所描述的肾缝合术是在控制台外科医生的完全控制下进行的，并且在我们的系列中已经证明可以减少热缺血时间。
