Category: Laparoscopic/ Robotic: Other

MP25-20 - Post-operative complications requiring procedural intervention in the modern era of robot-assisted laparoscopic partial nephrectomy

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

Throughout the last decade, the number of partial nephrectomies performed with a robot-assisted approach has continued to increase. We set out to analyze the rates of post-operative complications after robot-assisted laparoscopic partial nephrectomy (RALPN), specifically urinoma and arterial malformation. Furthermore, we explored the influence of experience on the incidence of these outcomes. A preliminary assessment of potential predictors of these complications was performed.


Methods :

Data was obtained from an ongoing IRB approved kidney cancer database. Inclusion criteria: all patients > 18 years old undergoing RALPN for suspected renal cell carcinoma (RCC). Dates of cases analyzed ranged from January 2014 to April 2018. Urinoma and arterial malformation were evaluated in all-comers.  Patients who developed pseudoaneurysm were compared to a control cohort. Pre-operative and intra-operative variables were compared between groups to analyze risk factors for pseudoaneurysm.


Results :

Results are displayed in Table and Table 2. We observe a relatively low rate of urinoma, renal artery pseudoaneruysm, and arteriovenous fistula. We report 7 pseudoaneurysms, all of which occurred between 2015 and 2016. Race, entry into the collecting system, and intraoperative blood loss were significantly associated with pseudoaneurysm.


Conclusions :

Complications after RALPN have decreased with experience. We report a low rate of urinoma: 0.32% among 311 RALPNS in our database. Arterial malformations were relatively more common albeit infrequent at 2.3% and 0.96%, respectively. Moreover, no urinoma or pseudoaneurysms occurred in the most recent years of our study, suggesting that the rates of these complications are declining with surgical experience. Race, collecting system entry, and intraoperative blood loss may be associated with pseudoaneurysm. As our database expands, we aim to further establish potential risk factors for these complications.

Jessica A. Connor

Medical student
Rutgers - New Jersey Medical School
Ridgewood, New Jersey

Radhika Ragam

Medical Student
Rutgers - New Jersey Medical School
Flemington, New Jersey

Benjamin Press

Medical Student
Rutgers - New Jersey Medical School
Newark, New Jersey

Saikrishnaraya Doppalapudi

Medical Student
Rutgers - New Jersey Medical School
Plainsboro, New Jersey

Thaiphi Luu

Medical Student
Rutgers - New Jersey Medical School
Cedar Brook, New Jersey

Thaiphi Luu, 4th year medical student, Rutgers New Jersey Medical School

Helaine Koster

Hackensack University Medical Center
Hackensack, New Jersey

Tenzin Lama-Tamang

Hackensack University Medical Center
Hackensack, New Jersey

John Stites

Fellow, Endourology, Laparoscopy, Robotic Surgery
Hackensack University Medical Center
Hackensack, New Jersey

Gregory Lovallo

Attending Urologist
Hackensack University Medical Center
Maywood, New Jersey

Mutahar Ahmed

Attending Urologist
Hackensack University Medical Center
Maywood, New York

Mutahar Ahmed MD FACS
Director of the Center for Bladder Cancer and Reconstructive Urologic Surgery at Hackensack University Medical Center, in Hackensack, NJ
Clinical Assitant Professor Hackensack Meridian Seton Hall School of Medicine
Clinical Assistant Professor Rutgers University School of Medicine

Ravi Munver

Professor & Vice Chair
Hackensack University Medical Center
Hackensack, New Jersey

Michael D. Stifelman

Chairman - Department of Urology
Hackensack University Medical Center
Hackensack, New Jersey