Category: Robotic Surgery: UpperTract - Malignant

VS7-6 - Da Vinci Robotic Assisted Laparoscopic Hemi-nephrectomy for Upper pole high risk tumors.

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

Da Vinci Si Robot assisted laparoscopic Heminephrectomy is gaining popularity in managing high risk upper polar renal tumours. It reduces the technical difficulty of parenchymal suturing during renorrhaphy. We aim to present the technique and outcomes of Laparoscopic (robot assisted) heminephrectomy.

Methods :

We analyzed 12 heminephrectomies (5-Left and 7-right sided) done from 2012 to 2017 for 12 Renal tumors (8-incidental & 4-hematuria) (All upper pole tumors) in 12 male patients. Our surgical approach included colon reflection, hilar dissection, tumour identification, tumour scoring, arterial clamping, tumour dissection, inner and outer renorrhaphy with PCS closure, declamping and specimen retrieval.

Results :

The mean age was 42 years (24-54). The median RENAL Nephrometry score was 10P with angiography showing single renal artery. The mean age & eGFR of the patient was 42 years & 112 ml/min/1.73m2 respectively. The mean console time, warm ischemia time, blood loss & hospitalization time was 143 mins, 26mins, 70 ml and 5 days respectively. Intra-operative and post-operative period were uneventful. On histopathology all tumour were Conventional Clear cell renal carcinomas. The patients were discharged on postoperative day 3. At 1 and 3 months of follow-up the patient were disease-free with minimal change in eGFR.

Conclusions :

In the hands of experienced surgeons, RAPN is a safe and reproducible approach for the treatment of challenging renal tumors. It is also effective in renal function preservation and oncologic control at an early follow-up interval. However more number of patients with long term outcomes data is necessary.

Santosh SUBHASH. Waigankar

Post Doctoral Fellow in Urooncology and Robotic Surgery
Kokilaben Dhirubhai Ambani Hospital
Mumbai, Maharashtra, India

Dr. Santosh Waigankar is a trained urologist from India who is presently pursuing urooncology and robotic surgery. After completing his training in urology, he decided to venture into subspecialty of urooncology and robotic surgery. He was selected as the first Vattikuti fellow in robotic urooncology in India (2015) and joined Kokilaben Dhirubhai Ambani hospital under the mentorship of Dr. T. B. Yuvaraja. He has been since associated with the department gaining valuable experience in Si and Xi DaVinci setups, as a beside and a console surgeon.

Fueled with curiosity and eagerness to learn he loves to interact with like-minded people across India and all over the world. He believes that gaining professional experience globally helps oneself to improve one’s perspective and broaden one’s approach to managing urological cancers.

He loves research and wants to work in areas as well looking into “unconventional” issues related to urological cancers as a whole e.g. molecular biology and ways to augment treatment outcomes in future. Doing research is his way of reciprocating back to the community.

His first international entry at the European Robotic Urology Society (ERUS 2017) won him the second prize for the best poster submission. The paper analyzed the “measured” outcomes post robotic partial nephrectomies. He has been awarded the scholarship for attending the 38th Société Internationale d'Urologie Congress (SIU 2018), scheduled to be held in Seoul.

He has keen interest in single port robotic surgery and aspires to get trained in the same.

He loves making friends from all walks of life and believes in knowledge sharing to enrich oneself. He is active on social media. He loves blogging and photography and follows cricket, tennis and F1 racing. Balancing between family, friends and professional life has been his priority always.

Yuvaraja Tb

Head of robotic surgery and urooncology
kokilaben dhirubhai ambani hospital
mumbai, Maharashtra, India

Srivathsan Ramani

Fellow - Robotic Urooncology
kokilaben dhirubhai ambani hospital
mumbai, Maharashtra, India

Abhinav Pednekar

Resident Surgical Oncology
Kokilaben Dhirubhai Ambani Hospital and Research Institute
Mumbai, Maharashtra, India