Robotic approach for complete endophytic tumors

KS Awards Finalist 5: This video is one of the 8- Finalists in consideration for the top three prizes to be announced February 6th, 2021: Robotic approach for complete endophytic tumors; Sunny Goel, Sachin Arakere Nataraj, Manav Suryavanshi, Rajesh Ahlawat- Medanta, The Medicity, Gurgaon

Introduction: Completely endophytic tumors are tumors not visible on renal surface. These tumors are challenging, needs expertise and use of intraoperative ultrasound. We have discussed our approach of managing these tumors using robotic technology. Methods: We analysed our records from 2010-2020. Twenty cases of endophyte tumors were operated during this time period. We assessed all the cases in terms of operating time, warm ischemia time, hospital stay and per-operative complications.

Results: We have operated 20 patients of endophytic tumors in last 10 years. Of these, 7 were parahilar, 9 were midpolar and 4 were polar. Warm ischemia time ranged from 20-26 min in parahilar tumors and 15-20 min in midpolar and polar tumors. Conversion to radical nephrectromy was required in 1 case, and conversion to open technique was required in 2 cases as we did not have intraoperative ultrasound before 2015. Two of our patients developed pseudoaneurysm which were managed by angio-embolization.

Conclusion: Completely endophytic tumors are complex, requires preoperative detailed study of CT-angiography films, imperative use of ultrasonography, and need of bloodless field. With use of robotic technology, these tumors can be operated with less perioperative morbidity, and maximal preservation of normal renal parenchyma in the patient.

CAUTION: contains narrated presentation of PowerPoints, Photos, Diagrams and robotic surgery footage, 07:29.