Modernization of surgical technique using a novel flexible aspirator-irrigator nozzle in robot-assisted surgery in a patient with a single kidney

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The article presents a clinical case of a 41-year-old patient with a rare genetic form of renal cell cancer. The patient underwent robot-assisted resection of the tumor of the single right kidney under conditions of "zero ischemia". During the operation a flexible aspirator-irrigator nozzle was used, which allowed optimal aspiration of fluid in places inaccessible for the stiff aspirator. The technique of the operation is described, the main perioperative parameters, oncologic and functional outcomes are summarized.

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作者简介

M. Mosoyan

Almazov National Medical Research Centre

编辑信件的主要联系方式.
Email: scapaflow12@gmail.com

Doctor of Medical Sciences, Professor

俄罗斯联邦, Saint Petersburg

D. Shelipanov

Almazov National Medical Research Centre

Email: scapaflow12@gmail.com

Candidate of Medical Sciences

俄罗斯联邦, Saint Petersburg

E. Gilev

Almazov National Medical Research Centre

Email: scapaflow12@gmail.com
俄罗斯联邦, Saint Petersburg

A. Vasilyev

Almazov National Medical Research Centre

Email: scapaflow12@gmail.com
俄罗斯联邦, Saint Petersburg

A. Simonyan

Almazov National Medical Research Centre

Email: scapaflow12@gmail.com
俄罗斯联邦, Saint Petersburg

参考

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2. Fig. 1. MSCT of the abdominal cavity and retroperitoneum with contrast: hypervascular masses in the left kidney are marked by arrows

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3. Fig. 2. Macropreparation of the removed left kidney

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4. Fig. 3. MSCT of the abdominal cavity and retroperitoneum – cystic formation of the right kidney (Bosniak IV); 3D-image of the kidney, main vessels, cysts created by the department's specialists

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5. Fig. 4. Surgical intervention: а – patient positioning; б – placement of endoscopic ports, the arrow indicates the assistant port (Hasson access); в – scheme of the operating team and patient's cart positioning

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6. Fig. 5. Intraoperative ultrasound of the right kidney cyst, solid component is highlighted with a red oval

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7. Fig. 6. Aspiration with an aspirator-irrigator of cyst fluid (a) and blood and clots (б) during resection of the right kidney

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8. Fig. 7. Suturing the bed of the removed neoplasm

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9. Fig. 8. MSCT with intravenous contrast 1 month after surgery, resection location

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