A CLINICAL CASE: ROBOT-ASSISTED PARTIAL NEPHRECTOMY WITH USING OF A NOVEL FLEXIBLE HEAD FOR ASPIRATOR-IRRIGATOR

Mosoyan Mkrtich Semyonovich, Shelipanov Denis Aleksandrovich, Fedorov Dmitry Aleksandrovich, Gilev Evgeny Sergeevich, Simonyan Artur Melikovich

The article presents a clinical case of robot-assisted partial nephrectomy using a new flexible head for an aspirator-irrigator. The surgical technique is described, the main perioperative indicators, as well as early oncological and functional outcomes are presented. Materials and methods: In a 57-year-old female patient, ultrasound and CT-scan data revealed a neoplasm of the right kidney, located in the upper pole, posteriorly, measuring 3.6*3.3 cm, intensively accumulating a contrast agent. At the Almazov National Medical Research Center an experienced robotic surgical team performed robot-assisted partial nephrectomy. Taking into account the complex location of the tumor, a flexible attachment for the aspirator-irrigator was used during the operation in order to more efficiently operate the instrument and facilitate the process of tumor resection itself. Results: The duration of the operation was 113 minutes. Console time was 72 minutes. The volume of blood loss did not exceed 50 ml. The warm ischemia time of the kidney was 14 minutes. In the intraoperative and early postoperative period, there were no complications or increases in serum creatinine and urea levels. The postoperative period proceeded without complications, the patient was discharged from the hospital on the 6th day after surgery. Histological examination revealed clear cell renal cell carcinoma, surgical margin was negative. According to the control CT-scan data six months after the operation, there were no signs of local recurrence. Conclusions. We present a clinical case of successful robot-assisted partial nephrectomy using a removable flexible head of an aspirator-irrigator. Thanks to the use of a new device, it is possible to effectively and safely perform this operation; moreover, the use of an attachment, in our opinion, can potentially facilitate the work of a console surgeon at the time of tumor resection, especially with complex tumor localization.

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