AB006. SOH24AB_210. Robotic retroperitoneal partial nephrectomy: a comprehensive video demonstration of retro-peritoneal anatomy from University Hospital Limerick

Background: Partial nephrectomy (PN) stands as a pivotal surgical procedure in the management of renal tumors, balancing oncological control with renal preservation. Robotic PN (RPN) is being increasingly adopted world-wide, however vast majority of RPN are performed via trans-peritoneal approach. Retro-peritoneal RPN (RRPN) is technically difficult because of smaller working space, unfamiliar anatomical space and landmarks for dissection. Thus, this video focuses on the retroperitoneal approach for RPN, offering a detailed perspective on this less common yet very important technique, as performed at University Hospital Limerick (UHL).

Methods: All 40 patients who underwent RRPN were discussed at our multi-disciplinary meeting prior to surgical planning using computed tomography (CT) reconstructed 3-D computer models. The video meticulously documents a real-life case of RRPN. It covers patient positioning, docking and the step-by-step surgical procedure. Key steps like the retro-peritoneal space creation, para-renal fat management, renal hilar dissection, tumor excision, and renal reconstruction are demonstrated in detail. The surgical team’s commentary provides insights into decision-making processes and technique optimization.

Results: The video elucidates the effective execution of a RRPN, showcasing aspects such as minimal invasiveness, optimal tumor access, and reduced risk of intra-abdominal organ injury. Postoperative outcomes, emphasizing renal function preservation and patient recovery, are briefly discussed.

Conclusions: This educational video from UHL serves as a valuable resource for urologists and surgical trainees, enhancing understanding of the retroperitoneal anatomy during PN. It underlines the approach’s viability and effectiveness, particularly in specific clinical scenarios, thereby contributing to broader surgical knowledge and patient care in the field of surgery.

Keywords: Robotic partial nephrectomy (RPN); retroperitoneal approach; renal tumor; surgical education; surgical operation