V10-02: Left partial robotic nephrectomy in renal tumor in a crossed renal ectopia with inferior renal fusion.
Partial nephrectomy was considered as a treatment of choice for localized RCC stages. For kidney malformations robotic partial nephrectomy can be considered as a technically challenging procedure. We present a case of a tumor in a left crossed renal ectopia with polar fusion in a young female patient with normal renal function.
Our patient is a 46 year old female affects of polymalformative genitourinary syndrome (double blind vagina, bicorne uterus and right renal agenesia with left compensatory hypertrophy kidney with double arterial pedicle and mesorrenal endofític 4,5 cm tumor).
We use a Da Vinci X1 system with 4 arm.Perioperative date revealed EBL of 250 cc and total warm isquemia time of 21 minutes (two arteries clamping). The serum creatinine elevated to 1,3 mg/dl and dropped down to 0,8 mg/dl in 48 hours. Final pathology reveales a pT1a clear cell carcinoma with negative margins and no complications.
Robotic assisted tumor resection seems like a feasible strategy to control and manteinance of renal function. The robotic approach facilitates renal mobilization, resection of the tumor as well as closure of the renal defect, thus reducing the warm ischemia times.