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. CONCLUSION: This approach enables excellent mobility for the robotic arms, generating no conflict and providing good maneuvering space for the bedside assistant.