title: Robotic retroperitoneal approach - a new technique for the upper urinary tract and adrenal gland.
abstract: BACKGROUND
  The retroperitoneal approach is generally avoided because of the reduced working space, the difficulties in robot positioning and the risk of arms conflict. A new robotic retroperitoneal approach is presented that can be applied for upper urinary tract pathology and adrenal pathology.
  
  
  METHODS
  Between November 2009 and November 2011, 34 out of 114 robotic procedures were performed by the retroperitoneal approach using a triangle shaped trocar placement and the robotic cart positioned at the patient's head.
  
  
  RESULTS
  All of the 34 retroperitoneal procedures were performed using this type of approach, with no conflict between the robotic arms and no conversions. The average operating time was 50 min for simple nephrectomies and 180 min for partial nephrectomies. The blood loss was not relevant.
  
  
  CONCLUSIONS
  This approach enables excellent mobility for the robotic arms, generating no conflict and providing good maneuvering space for the bedside assistant.
authors.affiliation: Clinical Municipal Hospital, Department of Urology, Cluj-Napoca, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Crisan
authors.forename: Calin
authors.initials: C
authors.lastname: Neiculescu
authors.forename: Deliu Victor
authors.initials: DV
authors.lastname: Matei
authors.forename: Ioan
authors.initials: I
authors.lastname: Coman
mesh_terms: D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: adrenalectomy; partial nephrectomy; pyeloplasty; retroperitoneal approach; robotic