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• W2089571888 abstract "You have accessJournal of UrologyRobotics, Single Port Surgery, LESS, NOTES1 Apr 2013V2159 ROBOT-ASSISTED LAPAROSCOPIC SIMPLE ENUCLEATION OF AN INTRAPARENCHYMAL HILUM ABUTTING RENAL TUMOR Lorenzo Masieri, Andrea Minervini, Matteo Salvi, Michele Lanciotti, Chiara Cini, Graziano Vignolini, Giampaolo Siena, Sergio Serni, Alberto Lapni, Marco Carini, and Marco Carini Lorenzo MasieriLorenzo Masieri Florence, Italy More articles by this author , Andrea MinerviniAndrea Minervini Florence, Italy More articles by this author , Matteo SalviMatteo Salvi Florence, Italy More articles by this author , Michele LanciottiMichele Lanciotti Florence, Italy More articles by this author , Chiara CiniChiara Cini Florence, Italy More articles by this author , Graziano VignoliniGraziano Vignolini Florence, Italy More articles by this author , Giampaolo SienaGiampaolo Siena Florence, Italy More articles by this author , Sergio SerniSergio Serni Florence, Italy More articles by this author , Alberto LapniAlberto Lapni Florence, Italy More articles by this author , Marco CariniMarco Carini Florence, Italy More articles by this author , and Marco CariniMarco Carini Florence, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2068AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present our surgical technique for Intraparenchymal RCC hilum abutting tumors to show advantages of robot-assisted Simple Tumour Enucleation (TE). METHODS We show our surgical technique for the treatment of completely intraparenchymal hilum abutting tumor in a 39 years old patient, with incidental diagnosis of 4cm left RCC. A 12mm trocar, two 8mm robotic trocars, a 8mm and a 10mm trocars for the bedside assistant are placed. After Da Vinci© docking, the kidney is completely separated from the perirenal fat to exclude satellite lesions not detected by the imaging technique; the renal pedicle is carefully isolated and the artery is selectively clamped before TE. Then the kidney capsule is sharply incised starting a few millimeters away from the lesion toward the peritumoral capsule; when the pseudocapsule is reached the tumor is enucleated by blunt dissection and scissors using the natural cleavage plane between the pseudocapsule and normal parenchyma. Adopting sliding clips technique, on the bed of resection bleeding vessels and openings in the collecting system are closed using a 3-zero monofilament running sutures. Then the artery is early declamped and the capsular sutures is performed with horizontal interrupted sutures of 2-0 Vicryl filament, apposing hemostatic agents. RESULTS Above all we performed 108 robotic assisted TE between 2011-2012 for RCC. Operation time: 140min. WIT: 17min. Intraoperative blood loss: 200cc. Length of hospital stay: 4 Days Creatinine serum III p.o. day: 0,91mg/dL. Pathologic outcome: Clear Cell RCC Fuhrman G2 3,5x3cm. Negative surgical margins. No evidence of tumour diffusion in peritumoral adipose tissues. pT1a pNx pMx CONCLUSIONS In case of intraparenchymal hilar tumours, thanks to image magnification and endo-wrist © movements, the Da Vinci Surgical System allows to perform TE in a feasible and safe manner. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e884 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lorenzo Masieri Florence, Italy More articles by this author Andrea Minervini Florence, Italy More articles by this author Matteo Salvi Florence, Italy More articles by this author Michele Lanciotti Florence, Italy More articles by this author Chiara Cini Florence, Italy More articles by this author Graziano Vignolini Florence, Italy More articles by this author Giampaolo Siena Florence, Italy More articles by this author Sergio Serni Florence, Italy More articles by this author Alberto Lapni Florence, Italy More articles by this author Marco Carini Florence, Italy More articles by this author Marco Carini Florence, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2089571888 title "V2159 ROBOT-ASSISTED LAPAROSCOPIC SIMPLE ENUCLEATION OF AN INTRAPARENCHYMAL HILUM ABUTTING RENAL TUMOR" @default.
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