Robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN): a prospective pilot study

ObjectiveTo investigate a novel intracorporeal minimally invasive procedure for robot assisted laparoendoscopic single-site partial nephrectomy.MethodsThis study reported our technique and the outcomes of a minimally invasive approach for partial nephrectomy, specifically robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN). A Freeport for LESS was inserted through a 4.5-5.0 cm skin incision. Instead of the traditional renal artery clamping technique, a Fogarty balloon catheter was used to occlude the renal artery or its branch. Tumor resection and wound suturing was then performed as routine steps.ResultsA total of 10 patients with T1 stage renal tumors underwent successful LESS-HPN from March to July 2023, with no conversions to renal artery clamping or additional ports. The mean operative time was 103.3 +/- 11.1 min, including 21.0 +/- 2.7 min of warm ischemia time. The mean estimated blood loss was 42.0 +/- 22.5 ml. Tumors located posteriorly were associated with shorter operative time compared to those located anteriorly (p = 0.041). Occlusion of the main renal arteries, branch arteries, and accessory renal artery was achieved in 7, 2 and 1 cases, respectively. During a median follow-up of 10.5 months, no recurrence, metastasis, or death was observed. Limitations of this study include the small sample size, the absence of a control group, and the relatively short follow-up duration.ConclusionsLESS-HPN has proven to be a safe and feasible alternative for achieving intracorporeal minimal invasiveness in patients with renal tumors.Trial RegistrationClinical trials were registered in September 4th, 2021, available at www.chictr.org.cn/ (ChiCTR2100050808). This article belongs to a selection of patients who were part of this clinical study.