Objective <p>To investigate a novel intracorporeal minimally invasive procedure for robot assisted laparoendoscopic single-site partial nephrectomy.</p> Methods <p>This study reported our technique and the outcomes of a minimally invasive approach for partial nephrectomy, specifically robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN). A Freeport for LESS was inserted through a 4.5–5.0&#xa0;cm skin incision. Instead of the traditional renal artery clamping technique, a Fogarty balloon catheter was used to occlude the renal artery or its branch. Tumor resection and wound suturing was then performed as routine steps.</p> Results <p>A total of 10 patients with T1 stage renal tumors underwent successful LESS-HPN from March to July 2023, with no conversions to renal artery clamping or additional ports. The mean operative time was 103.3 ± 11.1&#xa0;min, including 21.0 ± 2.7&#xa0;min of warm ischemia time. The mean estimated blood loss was 42.0 ± 22.5&#xa0;ml. Tumors located posteriorly were associated with shorter operative time compared to those located anteriorly (<i>p</i> = 0.041). Occlusion of the main renal arteries, branch arteries, and accessory renal artery was achieved in 7, 2 and 1 cases, respectively. During a median follow-up of 10.5 months, no recurrence, metastasis, or death was observed. Limitations of this study include the small sample size, the absence of a control group, and the relatively short follow-up duration.</p> Conclusions <p>LESS-HPN has proven to be a safe and feasible alternative for achieving intracorporeal minimal invasiveness in patients with renal tumors.</p> Trial Registration <p>Clinical trials were registered in September 4th, 2021, available at <a href="http://www.chictr.org.cn/">www.chictr.org.cn/</a> (ChiCTR2100050808). This article belongs to a selection of patients who were part of this clinical study.</p>

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Robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN): a prospective pilot study

  • Xu Shi,
  • Yang Yu,
  • Tianrun Ye,
  • Gan Yu,
  • Bin Xu,
  • Zheng Liu,
  • Ke Chen,
  • Wei Guan,
  • Shaogang Wang,
  • Heng Li

摘要

Objective

To investigate a novel intracorporeal minimally invasive procedure for robot assisted laparoendoscopic single-site partial nephrectomy.

Methods

This study reported our technique and the outcomes of a minimally invasive approach for partial nephrectomy, specifically robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN). A Freeport for LESS was inserted through a 4.5–5.0 cm skin incision. Instead of the traditional renal artery clamping technique, a Fogarty balloon catheter was used to occlude the renal artery or its branch. Tumor resection and wound suturing was then performed as routine steps.

Results

A total of 10 patients with T1 stage renal tumors underwent successful LESS-HPN from March to July 2023, with no conversions to renal artery clamping or additional ports. The mean operative time was 103.3 ± 11.1 min, including 21.0 ± 2.7 min of warm ischemia time. The mean estimated blood loss was 42.0 ± 22.5 ml. Tumors located posteriorly were associated with shorter operative time compared to those located anteriorly (p = 0.041). Occlusion of the main renal arteries, branch arteries, and accessory renal artery was achieved in 7, 2 and 1 cases, respectively. During a median follow-up of 10.5 months, no recurrence, metastasis, or death was observed. Limitations of this study include the small sample size, the absence of a control group, and the relatively short follow-up duration.

Conclusions

LESS-HPN has proven to be a safe and feasible alternative for achieving intracorporeal minimal invasiveness in patients with renal tumors.

Trial Registration

Clinical trials were registered in September 4th, 2021, available at www.chictr.org.cn/ (ChiCTR2100050808). This article belongs to a selection of patients who were part of this clinical study.