title: Simplified zero ischemia in robot assisted partial nephrectomy: initial yonsei experience.
abstract: OBJECTIVE
  To evaluate the safety and feasibility of a simplified zero ischemia technique using kidney donor computed tomographic (CT) angiography and conventional laparoscopic bulldog clamps.
  
  
  METHODS
  We conducted a review of seven robot-assisted partial nephrectomies (RAPNs) performed by a single surgeon from January 2012 to May 2012. Using a simplified protocol of 3-dimentional reconstruction, tertiary arterial branches supplying the tumor were selectively clamped prior to resection. We used conventional laparoscopic bulldog clamps instead of microsurgical vessel clamps. The patients' demographic information, perioperative outcomes, pathologic outcomes and pre- and postoperative renal functions up to 3 months follow-up were analyzed.
  
  
  RESULTS
  RAPN were successfully performed for seven complex renal hilar tumors. There were no significant differences in the total operation time, estimated blood loss or postoperative outcomes compared with published literature on standard RAPN. Negative surgical margins were reported in all cases.
  
  
  CONCLUSIONS
  We presented a simplified-zero ischemia technique using kidney Donor CT angiography and conventional laparoscopic bulldog clamps. We have also demonstrated its safety and feasibility in patients with complex renal hilar tumors. This modified technique can be easily adopted by most surgeons who are currently performing RAPN.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Shin
authors.forename: Kyung Hwa
authors.initials: KH
authors.lastname: Choi
authors.forename: Sey Kiat
authors.initials: SK
authors.lastname: Lim
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Kim
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lee
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Young Taik
authors.initials: YT
authors.lastname: Oh
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Jung
authors.forename: Woong Kyu
authors.initials: WK
authors.lastname: Han
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
keywords: Kidney cancer; Nephrectomy; Robotics; Three-dimensional image
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