414 T3b kidney tumors. Could robotics be new gold standard? Dr Nicola Frego скачать в хорошем качестве

414 T3b kidney tumors. Could robotics be new gold standard? Dr Nicola Frego

This video is being presented at the Humans at the Cutting Edge of Robotic Surgery Symposium 2024, Jaipur, India. It was produced by Dr Nicola Frego, Onze Lieve Vrouwziekenhuis hospital, ORSI Academy Aalst, Belgium. Abstract: T3b kidney tumors. Could robotics be new gold standard? Noya Mourullo, A.; Frego, N.; Pissavini,A.; Barletta, F.; Resca, S.; Lambert,E.; D’Hondt, F.; De Naeyer, G.; De Groote, R.; Mottrie, A. • Introduction and objectives Radical nephrectomy is the preferred treatment for tumors extending into inferior vena cava, includes T3b tumors. Robotic radical nephrectomy, has been increasingly utilized in the management of renal carcinoma, including complex cases such as T3b kidney tumors. • Methods 78-year-old male patient. BMI=32m2, on haemodialysis for CKD. Due to elevated CRP, a CT scan was performed showing 7.7cm right renal interpolar lesion with thrombus extension. It was decided to perform a robot-assisted radical nephrectomy and ultrasound-guided thrombectomy: under general anesthesia and robot docking (Da VinciXi system), confirmation of IVC thrombus with intraoperative ultrasound. Circumferential isolation of IVC proximal to the hepatic vein. Placement a tourniquet system on contralateral renal vein and other tourniquet on caudal end of IVC thrombus. Last tourniquet on cranial end of IVC thrombus. Ultrasound control of the vessel loop placement above the cranial end of thrombus. Cavotomy and thrombectomy. Suturing the IVC with two running non-absorbable monofilaments. Unclamping and removal of the tourniquet system. • Results Surgical Fme: 200 minutes with contralateral renal vein clamping Fme:22 min. Blood loss: 800cc. Discharge: 7th postoperaFve day. Pathological report: Furhman grade 3 renal clear cell carcinoma with hilar invasion and extension to the renal vein pT3b. • Conclusions Based on our experience and following previously published studies, we conclude that robotic- assisted surgery is a viable and safe option for T3b kidney tumors, performed by skilled surgeons in high-volume centers to optimize outcomes. See more at: http://vattikutifoundation.com/