Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass
Introduction & Objectives: Endophytic renal tumors pose challenge in achieving the purpose of Nephron sparing surgery (NSS) owing to their lack of visibility over kidney surface. Among these, deep & centrally located variants are notorious as their surgical management involves loss o...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Urology Video Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089725000088 |
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| author | Mahendra Pal Amandeep Arora Ankit Misra Ajit Gujela Uday Chandankhede Manoj Tummala Sugam Godse Ganesh Bakshi Santosh Menon Gagan Prakash |
| author_facet | Mahendra Pal Amandeep Arora Ankit Misra Ajit Gujela Uday Chandankhede Manoj Tummala Sugam Godse Ganesh Bakshi Santosh Menon Gagan Prakash |
| author_sort | Mahendra Pal |
| collection | DOAJ |
| description | Introduction & Objectives: Endophytic renal tumors pose challenge in achieving the purpose of Nephron sparing surgery (NSS) owing to their lack of visibility over kidney surface. Among these, deep & centrally located variants are notorious as their surgical management involves loss of more nephrons and relatively more compromised vascularity of the spared renal parenchyma. With advent of robotic-assisted interventions, increasing in-depth knowledge on safe ischemia time of kidney, multiple approaches to manage endophytic tumors offer swift post-operative renal recovery. The present video aims to demonstrate the Robotic-assisted ‘Oyster-pearl extraction technique’ via anatrophic nephrotomy in managing deep and centrally located endophytic tumors. Materials & Methods: An elderly female with morbid obesity, presented with a completely endophytic, centrally located left renal mass, size of 25 × 23 × 22 millimeter, with nephrometric score of 10a. On evaluation her Serum creatinine was 0.70 mg/dl, on DTPA scan, GFR of the right and the left kidney was 38 milliliter/minute and 35 milliliter/minute respectively, with no local or distant recurrence. Robotic-assisted ‘Oyster pearl extraction technique’ via anatrophic nephrotomy was performed for excision of the mass. Result: The operating time and warm ischemia time were 165 min and 35 min respectively, with blood loss of 200 ml. The post-operative hospital stay was of 2 days. Histopathology revealed conventional renal cell carcinoma and margins were free of tumor. At 3 months, Serum creatinine was 0.80 mg/dl, GFR of right and left kidney were 35 milliliter/minute and 31 milliliter/minute respectively, with no local or distant recurrence. Conclusion: Robotic-assisted ‘Oyster-pearl extraction technique’ via anatrophic nephrotomy offers a promising approach to manage centrally endophytic renal masses in patients with or without comorbidities with preservation of functional renal parenchyma, swift post-operative recovery along with accepted oncological outcome. |
| format | Article |
| id | doaj-art-91abcb7aa8a842529bab273b040e6e27 |
| institution | DOAJ |
| issn | 2590-0897 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj-art-91abcb7aa8a842529bab273b040e6e272025-08-20T03:17:26ZengElsevierUrology Video Journal2590-08972025-06-012610033210.1016/j.urolvj.2025.100332Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal massMahendra Pal0Amandeep Arora1Ankit Misra2Ajit Gujela3Uday Chandankhede4Manoj Tummala5Sugam Godse6Ganesh Bakshi7Santosh Menon8Gagan Prakash9Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India; Corresponding author.Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaDepartment of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, IndiaIntroduction & Objectives: Endophytic renal tumors pose challenge in achieving the purpose of Nephron sparing surgery (NSS) owing to their lack of visibility over kidney surface. Among these, deep & centrally located variants are notorious as their surgical management involves loss of more nephrons and relatively more compromised vascularity of the spared renal parenchyma. With advent of robotic-assisted interventions, increasing in-depth knowledge on safe ischemia time of kidney, multiple approaches to manage endophytic tumors offer swift post-operative renal recovery. The present video aims to demonstrate the Robotic-assisted ‘Oyster-pearl extraction technique’ via anatrophic nephrotomy in managing deep and centrally located endophytic tumors. Materials & Methods: An elderly female with morbid obesity, presented with a completely endophytic, centrally located left renal mass, size of 25 × 23 × 22 millimeter, with nephrometric score of 10a. On evaluation her Serum creatinine was 0.70 mg/dl, on DTPA scan, GFR of the right and the left kidney was 38 milliliter/minute and 35 milliliter/minute respectively, with no local or distant recurrence. Robotic-assisted ‘Oyster pearl extraction technique’ via anatrophic nephrotomy was performed for excision of the mass. Result: The operating time and warm ischemia time were 165 min and 35 min respectively, with blood loss of 200 ml. The post-operative hospital stay was of 2 days. Histopathology revealed conventional renal cell carcinoma and margins were free of tumor. At 3 months, Serum creatinine was 0.80 mg/dl, GFR of right and left kidney were 35 milliliter/minute and 31 milliliter/minute respectively, with no local or distant recurrence. Conclusion: Robotic-assisted ‘Oyster-pearl extraction technique’ via anatrophic nephrotomy offers a promising approach to manage centrally endophytic renal masses in patients with or without comorbidities with preservation of functional renal parenchyma, swift post-operative recovery along with accepted oncological outcome.http://www.sciencedirect.com/science/article/pii/S2590089725000088Robotic surgeryNephron-sparing surgeryEndophytic renal massRenal cell carcinomaOyster Pearl |
| spellingShingle | Mahendra Pal Amandeep Arora Ankit Misra Ajit Gujela Uday Chandankhede Manoj Tummala Sugam Godse Ganesh Bakshi Santosh Menon Gagan Prakash Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass Urology Video Journal Robotic surgery Nephron-sparing surgery Endophytic renal mass Renal cell carcinoma Oyster Pearl |
| title | Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass |
| title_full | Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass |
| title_fullStr | Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass |
| title_full_unstemmed | Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass |
| title_short | Robotic assisted anatrophic nephrotomy “oyster-pearl extraction technique” for deep and centrally located endophytic renal mass |
| title_sort | robotic assisted anatrophic nephrotomy oyster pearl extraction technique for deep and centrally located endophytic renal mass |
| topic | Robotic surgery Nephron-sparing surgery Endophytic renal mass Renal cell carcinoma Oyster Pearl |
| url | http://www.sciencedirect.com/science/article/pii/S2590089725000088 |
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