학술논문
The Transabdominal Lumbar Approach (TALA) for Robotic Renal Surgery-A Retrospective Single-Center Comparative Study and Step-by-Step Description of a Novel Approach.
Document Type
Academic Journal
Author
Heining FM; Department of Surgery, Division of Urology, Kantonsspital Baden, 5404 Baden, Switzerland.; Bieri U; Department of Surgery, Division of Urology, Kantonsspital Baden, 5404 Baden, Switzerland.; Niemann T; Department of Radiology, Kantonsspital Baden, 5404 Baden, Switzerland.; Maletzki P; Department of Surgery, Division of Urology, Kantonsspital Baden, 5404 Baden, Switzerland.; Tschung C; Department of Surgery, Division of Urology, Kantonsspital Baden, 5404 Baden, Switzerland.; Adank JP; Department of Surgery, Division of Urology, Kantonsspital Baden, 5404 Baden, Switzerland.; Rössler F; Department of Surgery and Transplantation, University Hospital Zürich, University of Zürich, 8006 Zürich, Switzerland.; Nocito A; Department of Surgery, Kantonsspital Baden, 5404 Baden, Switzerland.; Hefermehl LJ; Department of Surgery, Division of Urology, Kantonsspital Baden, 5404 Baden, Switzerland.
Source
Publisher: MDPI Country of Publication: Switzerland NLM ID: 101526829 Publication Model: Electronic Cited Medium: Print ISSN: 2072-6694 (Print) Linking ISSN: 20726694 NLM ISO Abbreviation: Cancers (Basel) Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2072-6694
Abstract
The transperitoneal approach (TP) and the retroperitoneal approach (RP) are two common methods for performing nephrectomy or partial nephrectomy. However, both approaches face difficulties, such as trocar placement and limited working space (RP). TP is impaired in the case of dorsal tumors and dissection of the renal artery can be challenging due to the anatomic localization dorsally to the renal vein. A hybrid approach that combines both methods has been previously reported in a case series, but not evaluated systematically. This study proposes a modified hybrid approach, which we call the transabdominal lumbar approach (TALA), involving late robotic docking after elaborating the retroperitoneum using conventional laparoscopy. The study compares the last 20 consecutive patients who underwent RP and the last 20 patients who underwent TALA at our institution. The investigated variables include operative time and amount of blood loss, hospitalization duration, postoperative analgesia requirement, and postoperative complications. The study found no significant difference in operative time, blood loss, ischemia time, or hospital stay between the two groups. The TALA group had fewer complications regarding Clavien-Dindo category 3, but one complication of category 4. In Conclusion, TALA is a safe and promising approach that combines the advantages of RP and TP.