Robotic Enucleation of Renal Hilar Tumour

This video shows a robotic enucleation of renal hilar tumour.

A 31 year old male presented with incidentally detected right renal mass. Ultrasound and CT abdomen were performed, which were suggestive of 2.5 x 2.4cm heterogeneously enhancing mass lesion consistent with renal cell carcinoma abutting right renal pelvis and collecting system in close proximity to renal vessels and branches. Robotic partial nephrectomy/ enucleation was planned. DaVinci Si robotic surgery system was used. Patient was placed in lateral position. Two robotic ports (8mm), one camera port (12mm) and two assistant ports were placed. Hilar dissection was performed and renal artery and vein were looped. Renal artery was branching into three branches and tumour was located in between arterial branches. The tumour could be separated off the branches and feeders were coagulated. The tumor was enucleated by blunt dissection and scissors using the natural cleavage plane between the pseudocapsule and normal parenchyma. Histopathology surprisingly revealed “anastomosing hemangioma” with no evidence of malignancy.

Video by Aditya A. Kulkarni, Muralidhar Achar, Prashanth Kulkarni.