Partial nephrectomy technique cuts warm ischemia

A procedure designed to streamline robotic partial nephrectomy significantly reduces warm ischemia time (WIT) by nearly 25%, according to a recent analysis.

The study, which was published online in the Journal of Endourology (June 12, 2012), confirms that the first assistant sparing technique (F.A.S.T) achieves the same results as standard robotic partial nephrectomy surgery in much less time, regardless of tumor size, location, or complexity. The F.A.S.T. incorporates steps typically performed by surgical assistants into the robotic process.

"By incorporating F.A.S.T. into our robotic approach, for the first time we were able to cut WIT down to an average of 15 minutes-and 18 minutes for more complicated tumors," said lead author Ketan K. Badani, MD, of New York-Presbyterian Hospital/Columbia University Medical Center, New York. "As a result, we’re able to offer a minimally invasive partial nephrectomy to almost anyone with a renal tumor, regardless of its size or complexity."

The results were confirmed by comparing F.A.S.T. with standard robotic techniques in a retrospective 6-month review of 44 patients who underwent robotic partial nephrectomy. F.A.S.T. was as efficient as the standard robotic approach at completely excising a tumor with no positive surgical margins, despite tumor size or location, or other complicating factors.

With F.A.S.T., a series of steps typically performed by surgical assistants-ultrasound, clamping to cut off and restore blood flow to the kidney, passing of needles, and stitches-can be incorporated into the robotic process, shaving off critical WIT minutes, the New York surgeons say.

Look for more on techniques aimed at reducing renal ischemia in the October issue of Urology Times.

Go back to this issue of Urology Times eNews.

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