Robotic partial nephrectomy with selective parenchymal compression (Simon clamp)

Abstract

Objective: To present our initial experience using selective renal parenchymal ischemia, without hilar clamping, in robotic-assisted partial nephrectomy.

Material and methods: In four patients with T1a renal tumor we performed robotic-assisted partial nephrectomy, using the Simon's clamp (Aesculap). It provides selective parenchymal compression without the need of vascular clamping. All patients had exofitic renal tumors in polar location. Renal parenchymal reconstruction was done as the standard technique.

Results: The median age was 49.6 years (42-59), 3 male and 1 female patient. Median operative time was 71,6 minutes (40-120). Mean stimated bleeding was 250 ml (50-400). Average tumor size was 3,25 cm (1,5-5,3). There were no complications and the average hospital stay was 3,5 days (1-7). The pathology was informed as renal cell carcinoma in three patients and one hemorrhagic cyst. The surgical margins were negative.

Conclusion: Our preliminary results shows that selective renal parenchymal compression, with the Simon's clamp, provides an alternative to vascular control in selected patients with polar renal tumors.

Keywords: Cirugía conservadora de nefronas; Cirugía robótica; Laparoscopia; Laparoscopy; Nefrectomía parcial; Nephron-sparing surgery; Partial nephrectomy; Renal tumor; Robotic surgery; Tumor renal.