Case report: robot-assisted partial nephrectomy in patient with large tumor (T2)

摘要

The present article describes a clinical case of a robot-assisted surgery performed for a large tumor of the right kidney. Here, the surgery technique is described, and the main perioperative indicators are listed. Materials and Methods . A 39 year old man, according to ultrasound and MRI, revealed the growth of a right kidney in the upper third of the cyst measuring 105 × 85 × 79 mm with clear even borders, and a density of content from 13 to 22 HU, with vascularized vegetations along the capsule, and moderate contrast accumulation in thin partitions (Bosniak IV), the cyst deforms the sinus of the kidney in the upper section, the perinephral tissue was not infiltrated. Results . Kidney tumor was removed within healthy tissue. The total operating time was 290 minutes, while the surgical console time was 255 minutes. The volume of blood loss did not exceed 150 ml. The thermal kidney ischemia lasted for 33 minutes. The hemoglobin level was decreased by 10%, and the number of red blood cells — by 14 %. An increase in serum creatinine and urea levels was not observed. Patient spent one day in intensive care unit. After the surgery, two drains were placed to the resection area and were removed after the 4 and 5 days. The patient was discharged from the hospital on the 10th day after the operation. Conclusions . Here, we reported a clinical case of robot-assisted resection of a large kidney tumor in a young patient. The advantages of robot-assisted surgery are associated with excellent visualization, as well as precision and accuracy of movements, together with a high level of surgical experience, it reduces the risk of intra- and post-operative complications and the nephrectomy associated with them. The young age of the patient and the high risk of possible nephrectomy, in our opinion, could be the justification for performing robot-assisted interventions, reducing the risk of nephrectomy development.