Sutureless Robot Assisted PN

• 30 Jan 2020 11:39:48 AM
• |Onco Urology

Dear All,

 A technique of sutureless Robot Assisted Partial Nephrectomy using ‘Soft Coagulation’ is being described. It is mentioned that in Soft Coagulation Mode, the output voltage is regulated <190 V and generates Joule heat without producing sparks that cause tissue carbonization (setting of 7 and 80 V).

https://www.liebertpub.com/doi/10.1089/vid.2019.0096?utm_source=sfmc&utm_medium=email&utm_campaign=END%20VID%20FP%20Jan%2027%202020&d=1/27/2020&mcid=23900981

(link available till Feb 10^th only)

How many of us are performing such sutureless technique when performing PN for Renal Masses.

Is it more advantageous than using sutures at the tumour resected site?

I am sure many who perform PN regularly can provide an answer for the same.

With warm Regards,

Venu

Comments(1)

• 

  Amrith Raj Rao

  30 Jan 2020 03:34:56 PM

  Dear Prof

  
  

  Thanks for sharing the video. The video makes it convincing. I am not aware of anyone in India who is performing this technique or indeed other centres in the US or Europe. 

  
  

  A few points. 

  
  

  The main renal artery is clamped. Therefore, the excision and coag is done with WIT, which they have elucidated. It just feels uncomfortable not to take the inner renorraphy stitch as one may percieve that these can rebleed later. Second point is that for many smaller exophytic tumours, many of us would excise without any renal artery clamp (especially whenn you are delaing with multiple tumours) and coagulate the base without much renorraphy. Suggesting that coagulation may be sufficient. However, if you want a peaceful night, then renorraphy does give that comfort. Also, they have described in the abstract, development of Ureteric Stricture due to possible heat conduction. This needs to be borne in mind. 

  
  

  Warm Regards