V1085: Robotic partial nephrectomy using selective arterial clamping with near infrared fluorescence imagin

V1085: Robotic partial nephrectomy using selective arterial clamping with near infrared fluorescence imaging in patients with absolute indications

Video

Introduction and Objectives
Near infrared fluorescence (NIRF) imaging is a technology with emerging application in urologic surgery as it provides anatomical and functional information in real time. We present our surgical technique of selective arterial clamping with NIRF imaging in patients with absolute indications.

Methods
A retrospective cohort study was performed from April 2011 to October 2012 in prospectively maintained, institutional review board-approved database. We included all patients with absolute indications for partial nephrectomy in which successful selective clamping and NIRF imaging were utilized. Absolute indication for partial nephrectomy was defined as patients with bilateral renal tumors, a solitary kidney, or eGFR 2. Using a high definition recording system and iMovie software with narrative and annotative editing we created a video outlining this complex procedure. In this video we review our technique for selective clamping using NIRF imaging in a patient with a solitary kidney and a patient with multiple bilateral renal tumors.

Results
Between April, 2011 to October, 2012 we performed 97 partial nephrectomies, of which 6 patients underwent a total of 10 selective clamping partial nephrectomies using NIRF imaging for absolute indications. This data is presented in Table 1 and Table 2.

Conclusions
This video presents our technique for selective arterial clamping in patients with absolute indications using intraoperative NIRF imaging. In our early experience this technique appears safe and effective in minimizing warm ischemia damage to the kidney as shown by an change in eGFR of only 2.8 ml/min per 1.73 m2 and a percentage change of