Robot-assisted laparoscopic partial nephrectomy in patients with previous abdominal surgery: single center experience

Int J Med Robot. 2015 Dec;11(4):389-94. doi: 10.1002/rcs.1633. Epub 2015 Jan 19.

Abstract

Background: The aim of this study is to report our single center experience with robotic partial nephrectomy (RPN) in patients with history of previous abdominal surgery (PAS).

Methods: Medical records of patients who underwent RPN for a single renal mass in our center from 2006 to 2013 were reviewed. Patients were divided in two groups: those who had history of PAS and those without history of PAS. Within the PAS group, four sub-groups were considered: (a) remote site of PAS in relation to RPN; (b) PAS in the proximity of RPN site; (c) previous umbilical hernia/abdominal hernia mesh repair; (d) major PAS.

Results: In total 627 patients were analyzed, and of these 321 patients had history of PAS (51.2%). On univariable and multivariable analyses, only Charlson Comorbidity Index, estimated blood loss, and tumor size were the significant predictors of complications.

Conclusions: RPN can be safely performed in patients with history of PAS with surgical outcomes comparable with those obtained in patients without history of PAS.

Keywords: Hasson technique; Veress needle; previous abdominal surgery; robotic partial nephrectomy; trocar related injury.

Publication types

  • Comparative Study

MeSH terms

  • Abdomen / pathology
  • Abdomen / surgery
  • Comorbidity
  • Female
  • Humans
  • Kidney Neoplasms / epidemiology*
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Laparoscopy / statistics & numerical data*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / statistics & numerical data
  • Nephrectomy / statistics & numerical data*
  • Ohio / epidemiology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Robotic Surgical Procedures / statistics & numerical data*
  • Treatment Outcome