title: Robotic surgery and hemostatic agents in partial nephrectomy: a high rate of success without vascular clamping.
abstract: Robot-assisted partial nephrectomy has been proposed as a technique to overcome technical challenges of laparoscopic partial nephrectomy. We prospectively collected and analyzed data from 31 patients who underwent robotic partial nephrectomy with systematic use of hemostatic agents, between February 2009 and October 2014. Thirty-three renal tumors were treated in 31 patients. There were no conversions to open surgery, intraoperative complications, or blood transfusions. The mean size of the resected tumors was 27 mm (median 20 mm, range 5-40 mm). Twenty-seven of 33 lesions (82%) did not require vascular clamping and therefore were treated in the absence of ischemia. All margins were negative. The high partial nephrectomy success rate without vascular clamping suggests that robotic nephron-sparing surgery with systematic use of hemostatic agents may be a safe, effective method to completely avoid ischemia in the treatment of selected renal masses.
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.|EndoCAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Morelli
authors.affiliation: Department of Radiology, St. John's Medical Center, Tulsa, OK, USA.
authors.forename: John
authors.initials: J
authors.lastname: Morelli
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy. palmeri.matteo@gmail.com.
authors.forename: Matteo
authors.identifier: http://orcid.org/0000-0002-9343-278X
authors.initials: M
authors.lastname: Palmeri
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: D'Isidoro
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Emanuele Federico
authors.initials: EF
authors.lastname: Kauffmann
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Tartaglia
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caprili
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.|EndoCAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pisano
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Guadagni
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Di Franco
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Di Candio
authors.affiliation: EndoCAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*
chemical_list: D006490:Hemostatics
keywords: Hemostatic agents; Partial nephrectomy; Renal carcinoma; Robotic surgery