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Technical innovations
Kidney ventrally rotation technique in retroperitoneal robot-assisted partial nephrectomy for posterior hilar tumor: technical feasibility and preliminary results
Jiangping Gao
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4092-1141
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Purpose: The retroperitoneal robotic assisted partial nephrectomy (RAPN) is suitable for tumors locating on the posterior side of the kidney. However, the posterior hilar tumor poses additional surgical challenge due to the special location and poor tumor exposure. We developed a novel kidney ventrally rotation technique to overcome this difficulty during retroperitoneal RAPN, and evaluated its efficacy in a retrospective case-control comparative .
Methods: From March 2016 to April 2019, a total of 39 patients with posterior renal hilar tumor underwent retroperitoneal RAPN. The kidney ventrally rotation technique, which improved the tumor exposure by opening the peritoneum and rotating the kidney ventrally, was applied in 24 cases and the conventional RAPN was performed in the other 15 cases (control group). Perioperative data was analyzed to evaluate the efficacy of the kidney ventrally rotation technique.
Results: In kidney rotation group, the 24 patients underwent RAPN successfully without converting to open surgery or radical nephrectomy. The warm ischemia time was 17.4 ± 6.6 min, which was significantly shorter than 24.5 ± 8.3 min in control group. The mean operation time (80 ± 24 min) and estimated blood loss (104 ± 65 ml) were not different from control group. No sever complications occurred, and no positive surgical margin was found in all the malignant cases. After 14 months follow-up, no recurrence or metastasis occurred in all cases.
Conclusion: Kidney ventrally rotation technique is safe and feasible for improving the exposure of posterior renal hilar tumor during retroperitoneal RAPN. It could be regarded as an efficient option for the management of posterior hilar tumor.
Keywords
robotic surgery, partial nephrectomy, posterior hilar tumor, retroperitoneal approach, kidney rotation
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CURRENT STATUS: Published
Version 2
Posted 13 Jun, 2020
Published
On 30 Jun, 2020
No community comments so far
Editorial decision: Accept
On 18 Jun, 2020
Review #1 received
Received 16 Jun, 2020
Review #2 received
Received 16 Jun, 2020
Reviewer #2 agreed
On 11 Jun, 2020
Reviewer #1 agreed
On 11 Jun, 2020
Reviewers invited
Invitations sent on 10 Jun, 2020
Editor assigned
On 08 Jun, 2020
Submission checks complete
On 07 Jun, 2020
Editor invited
On 07 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 18 May, 2020
Reviewer #4 agreed
On 14 May, 2020
Reviewer #3 agreed
On 08 May, 2020
Review #3 received
Received 08 May, 2020
Review #2 received
Received 08 May, 2020
Review #1 received
Received 20 Apr, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Reviewer #1 agreed
On 08 Apr, 2020
Reviewers invited
Invitations sent on 04 Apr, 2020
Editor assigned
On 02 Apr, 2020
First submitted
On 01 Apr, 2020
Submission checks complete
On 01 Apr, 2020
Editor invited
On 01 Apr, 2020
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This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Technical innovations
Kidney ventrally rotation technique in retroperitoneal robot-assisted partial nephrectomy for posterior hilar tumor: technical feasibility and preliminary results
Jiangping Gao
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4092-1141
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 13 Jun, 2020
Published
On 30 Jun, 2020
No community comments so far
Editorial decision: Accept
On 18 Jun, 2020
Review #1 received
Received 16 Jun, 2020
Review #2 received
Received 16 Jun, 2020
Reviewer #2 agreed
On 11 Jun, 2020
Reviewer #1 agreed
On 11 Jun, 2020
Reviewers invited
Invitations sent on 10 Jun, 2020
Editor assigned
On 08 Jun, 2020
Submission checks complete
On 07 Jun, 2020
Editor invited
On 07 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 18 May, 2020
Reviewer #4 agreed
On 14 May, 2020
Reviewer #3 agreed
On 08 May, 2020
Review #3 received
Received 08 May, 2020
Review #2 received
Received 08 May, 2020
Review #1 received
Received 20 Apr, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Reviewer #1 agreed
On 08 Apr, 2020
Reviewers invited
Invitations sent on 04 Apr, 2020
Editor assigned
On 02 Apr, 2020
First submitted
On 01 Apr, 2020
Submission checks complete
On 01 Apr, 2020
Editor invited
On 01 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Purpose: The retroperitoneal robotic assisted partial nephrectomy (RAPN) is suitable for tumors locating on the posterior side of the kidney. However, the posterior hilar tumor poses additional surgical challenge due to the special location and poor tumor exposure. We developed a novel kidney ventrally rotation technique to overcome this difficulty during retroperitoneal RAPN, and evaluated its efficacy in a retrospective case-control comparative .
Methods: From March 2016 to April 2019, a total of 39 patients with posterior renal hilar tumor underwent retroperitoneal RAPN. The kidney ventrally rotation technique, which improved the tumor exposure by opening the peritoneum and rotating the kidney ventrally, was applied in 24 cases and the conventional RAPN was performed in the other 15 cases (control group). Perioperative data was analyzed to evaluate the efficacy of the kidney ventrally rotation technique.
Results: In kidney rotation group, the 24 patients underwent RAPN successfully without converting to open surgery or radical nephrectomy. The warm ischemia time was 17.4 ± 6.6 min, which was significantly shorter than 24.5 ± 8.3 min in control group. The mean operation time (80 ± 24 min) and estimated blood loss (104 ± 65 ml) were not different from control group. No sever complications occurred, and no positive surgical margin was found in all the malignant cases. After 14 months follow-up, no recurrence or metastasis occurred in all cases.
Conclusion: Kidney ventrally rotation technique is safe and feasible for improving the exposure of posterior renal hilar tumor during retroperitoneal RAPN. It could be regarded as an efficient option for the management of posterior hilar tumor.
Figure 1
Figure 2
Figure 3