title: Robotic-assisted partial nephrectomy: experience on 60 cases.
abstract: BACKGROUND
  Laparoscopic partial nephrectomy is still one of the more challenging procedures in urology. Minimizing warm ischemia time (WIT) and bleeding requires efficient intracorporeal suturing. In addition, achieving negative surgical margins requires complete excision of the tumor. Robotic-assisted partial nephrectomy (RALPN) adds the advantages offered by the "Da Vinci system" to laparoscopy, such as the 3-D vision, and the better degree of freedom of surgical instruments.
  
  
  OBJECTIVE
  The objective of this study is to report our experience with RALPN.
  
  
  METHODS
  From August 2009 to October 2012, 60 patients underwent RALPN for kidney cancer. The average age of the patients (35 female, 25 male) was 63 (range 48-80) years. Average BMI was 25 (range 21.8-29.7) kg/m2. Average tumor size was 3.2 cm (range 2-6.7 cm). All the procedures were performed by a transperitoneal approach. Ilar clamping was used in all cases: in 47 patients by one intracorporeal tourniquet for the artery and one for the vein; in three cases, ilar clamping was "en block" by Satinsky.
  
  
  RESULTS
  Mean operative time was 167.2 min (140-250) with a WIT of 23.8 min (15-28). The mean estimated blood loss was 260 mL (50-300). In one case, nephrectomy was necessary because the tumor involved the renal pedicle. One patient had pulmonary embolism and one urinary leakage conservatively managed.Pathologic examination revealed clear cell renal cell carcinoma in 58 patients, oncocytoma in one patient, and angiomyolipoma in one patient. All resection margins were free from tumor.
  
  
  CONCLUSIONS
  Partial nephrectomy, facilitated by robotic technology, is more and more frequently performed as a safe and effective minimally invasive procedure.
authors.affiliation: Department of Urology, San Bassiano Hospital, Bassano del Grappa (Vicenza) - Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Zeccolini
authors.forename: Bernardino
authors.initials: B
authors.lastname: de Concilio
authors.forename: Dario
authors.initials: D
authors.lastname: Del Biondo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gallo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Silvestre
authors.forename: Antonio
authors.initials: A
authors.lastname: Celia
mesh_terms: D018249:Adenoma, Oxyphilic / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D018207:Angiomyolipoma / Q000601:surgery*; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome