Hyperaccuracy Three-dimensional Reconstruction Is Able to Maximize the Efficacy of Selective Clamping During Robot-assisted Partial Nephrectomy for Complex Renal Masses

Conclusions Preoperative simulation of selective ischemia was feasible and effective with HA3D reconstruction. In all the RAPN cases performed, selective clamping was successful, avoiding ischemia of the healthy renal remnant. A strict collaboration between urologists and bioengineers is mandatory to improve the technology. Patient summary In this report, we found that an accurate three-dimensional reconstruction of the kidney before conservative surgery for renal cancer seems to help in avoiding the global ischemia of the kidney. Further studies are needed to conclude if avoiding a percentage of ischemia to the kidney is clinically relevant. Preoperative simulation of selective ischemia was feasible with hyperaccuracy three-dimensional reconstruction. With this technology, fluorescence guidance became a double check of the correct planning of the selective clamping. Indeed, selective clamping was more successful and ischemia to the healthy parenchyma was avoided.
Source: European Urology - Category: Urology & Nephrology Source Type: research