V1087: Robotic Partial Nephrectomy in a Patient with an Orthotopic Liver Transplant
VideoIntroduction and Objectives
There is no consensus in the current literature regarding robotic vs. open partial nephrectomy in patients with prior abdominal surgery. In this video, we demonstrate robotic partial nephrectomy in a patient with prior liver transplant ith multiple abdominal adhesions.
This is a 40 year old male with a history of liver transplant in 2003. MRI with contrast in April 2012 revealed 1.6 x 1.9 x 2.1 cm mass within the upper pole the right kidney, compatible with a renal cell carcinoma. Patient underwent robotic right partial nephrectomy in July 2012.
The procedure was completed without any complication. Estimated blood loss was 150cc. Preoperative creatinine was 1.0 and Postoperative creatinine was stable around 1.2. Renal Scan showed the differential renal function was 42% right and 58% left postoperatively. Preoperatively, the split function was 45% on the right and 55% on the left. Pathology revealed clear cell renal cell carcinoma. Patient was discharged postoperative day 4.
We demonstrate that robotic partial nephrectomy is possible without any complications in the setting of a prior liver transplant with multiple intrabdominal adhesions and difficult anatomy.