Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects
ABSTRACT Introduction Robot-Assisted Single Site Radical Nephrectomy (RASS-RN) has been reported by surgeons in Europe and United States (1–3). To our best knowledge this video presents the first RASS-RN with concomitant cholecystectomy performed in Latin America. Case A 66 year-old renal transpla...
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doaj-f1a11f59bdf74c4f88952e0cb4a354552020-11-25T00:02:26ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-611944120220310.1590/s1677-5538.ibju.2016.0560S1677-55382018000100202Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspectsFrancisco Hidelbrando Alves Mota FilhoLuis Felipe SávioRafael Eiji SakataRenato Fidelis IvanovicMarco Antonio Nunes da SilvaRonaldo Soares MaiaCarlo Camargo PasserottiABSTRACT Introduction Robot-Assisted Single Site Radical Nephrectomy (RASS-RN) has been reported by surgeons in Europe and United States (1–3). To our best knowledge this video presents the first RASS-RN with concomitant cholecystectomy performed in Latin America. Case A 66 year-old renal transplant male due to chronic renal failure presented with an incidental 1.3cm nodule in the upper pole of the right kidney. In addition, symptomatic gallbladder stones were detected. Results Patient was placed in modified flank position. Multichannel single port device was placed using Hassan's technique through a 3 cm supra-umbilical incision. Standard radical nephrectomy and cholecystectomy were made using an 8.5mm camera, two 5mm robotic arms and an assistant 5mm access. Surgery time and estimated blood loss were 208 minutes and 100mL, respectively. Patient did well and was discharged within less than 48 hours, without complications. Pathology report showed benign renomedullary tumor of interstitial cells and chronic cholecystitis. Discussion Robotic technology improves ergonomics, gives better precision and enhances ability to approach complex surgeries. Robot-assisted Single Port aims to reduce the morbidity of multiple trocar placements while maintaining the advantages of robotic surgery (2). Limitations include the use of semi-rigid instruments providing less degree of motion and limited space leading to crash between instruments. On the other hand, it is possible to perform complex and concomitant surgeries with just one incision. Conclusion RASS-RN seems to be safe and feasible option for selected cases. Studies should be performed to better understand the results using single port technique in Urology.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000100202&lng=en&tlng=en |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Francisco Hidelbrando Alves Mota Filho Luis Felipe Sávio Rafael Eiji Sakata Renato Fidelis Ivanovic Marco Antonio Nunes da Silva Ronaldo Soares Maia Carlo Camargo Passerotti |
spellingShingle |
Francisco Hidelbrando Alves Mota Filho Luis Felipe Sávio Rafael Eiji Sakata Renato Fidelis Ivanovic Marco Antonio Nunes da Silva Ronaldo Soares Maia Carlo Camargo Passerotti Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects International Brazilian Journal of Urology |
author_facet |
Francisco Hidelbrando Alves Mota Filho Luis Felipe Sávio Rafael Eiji Sakata Renato Fidelis Ivanovic Marco Antonio Nunes da Silva Ronaldo Soares Maia Carlo Camargo Passerotti |
author_sort |
Francisco Hidelbrando Alves Mota Filho |
title |
Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects |
title_short |
Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects |
title_full |
Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects |
title_fullStr |
Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects |
title_full_unstemmed |
Robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects |
title_sort |
robot-assisted single port radical nephrectomy and cholecystectomy: description and technical aspects |
publisher |
Sociedade Brasileira de Urologia |
series |
International Brazilian Journal of Urology |
issn |
1677-6119 |
description |
ABSTRACT Introduction Robot-Assisted Single Site Radical Nephrectomy (RASS-RN) has been reported by surgeons in Europe and United States (1–3). To our best knowledge this video presents the first RASS-RN with concomitant cholecystectomy performed in Latin America. Case A 66 year-old renal transplant male due to chronic renal failure presented with an incidental 1.3cm nodule in the upper pole of the right kidney. In addition, symptomatic gallbladder stones were detected. Results Patient was placed in modified flank position. Multichannel single port device was placed using Hassan's technique through a 3 cm supra-umbilical incision. Standard radical nephrectomy and cholecystectomy were made using an 8.5mm camera, two 5mm robotic arms and an assistant 5mm access. Surgery time and estimated blood loss were 208 minutes and 100mL, respectively. Patient did well and was discharged within less than 48 hours, without complications. Pathology report showed benign renomedullary tumor of interstitial cells and chronic cholecystitis. Discussion Robotic technology improves ergonomics, gives better precision and enhances ability to approach complex surgeries. Robot-assisted Single Port aims to reduce the morbidity of multiple trocar placements while maintaining the advantages of robotic surgery (2). Limitations include the use of semi-rigid instruments providing less degree of motion and limited space leading to crash between instruments. On the other hand, it is possible to perform complex and concomitant surgeries with just one incision. Conclusion RASS-RN seems to be safe and feasible option for selected cases. Studies should be performed to better understand the results using single port technique in Urology. |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000100202&lng=en&tlng=en |
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