V7-09: Salvage robotic kidney surgery after complications of robotic partial nephrectomy

Video

Introductions and Objectives
Major complications of robotic partial nephrectomy (RPN) are rare, particularly the need for surgical intervention. In this video, we show two cases of salvage kidney surgery following complications of RPN and demonstrate the challenges involved.

Methods
The first patient had undergone a right lower pole heminephrectomy for a 3-cm hilar tumor abutting the renal pelvis. Post-operatively, he developed a urine leak, which resolved with percutaneous drainage and a ureteral stent. At 6-month follow-up, he presented with right hydronephrosis and
Results
The results of the two cases are presented in Table 1. Both cases were completed robotically with no intraoperative complications. Post-operative course was uneventful and both the patients were discharged on day three.

Conclusions
Salvage robotic kidney surgery for complications of robotic partial nephrectomy is rare but challenging. Intraoperative ultrasound, intraoperative doppler, the fourth robotic arm, and robotic hook can all be useful to define anatomy and facilitate dissection in difficult cases.

Funding: none