Retroperitoneoscopic robot-assisted laparoscopic partial nephrectomy during the second trimester of pregnancy: a case report and literature review.

INTRODUCTION AND IMPORTANCE

The incidental discovery of renal tumors during pregnancy necessitates a tailored treatment that carefully balances the health and well-being of both the mother and the developing fetus.

CASE PRESENTATION

The patient accidentally found a renal mass on abdominal ultrasound in the second trimester, and following MRI diagnosed cT1bN0M0 renal cancer. Following a multidisciplinary consultation and taking into account the patient's clinical status and preferences, retroperitoneoscopic robot-assisted laparoscopic partial nephrectomy (rRAPN) was successfully performed at 26 weeks of gestation. The procedure was completed without any postoperative complications and clear cell renal cell carcinoma was confirmed by histopathology. The postoperative recovery of the patient was uneventful and the baby was born safely at 38 weeks of gestation.

CLINICAL DISCUSSION

Gestational renal tumor is usually detected by routine antenatal ultrasonography incidentally without any typical symptoms, of which 50 % are malignant. The clinical decision-making process poses significant challenges, necessitating meticulous risk-benefit analysis to balance tumor control efficacy with perinatal safety. The two principal surgical approaches for renal tumor resection are the transperitoneal and retroperitoneoscopic routes, with selection guided by tumor location, surgeon expertise, and patient-specific anatomical considerations.

CONCLUSION

rRAPN is safe and effective in the second trimester. Personalized treatment should be made for each gestational RCC by a multidisciplinary team.