V Cornejo-Dávila1, M Nazmy2, N Kella3, M A Palmeros-Rodríguez4, J G Morales-Montor4, C Pacheco-Gahbler4. 1. División de Urología, Hospital General «Dr. Manuel Gea González», S.S.A., México, D.F., México. Electronic address: cornejomd@gmail.com. 2. The Urology and Prostate Institute, San Antonio, Texas, Estados Unidos de, América. 3. The Urology Place , San Antonio, Texas, Estados Unidos de, América. 4. División de Urología, Hospital General «Dr. Manuel Gea González», S.S.A., México, D.F., México.
Abstract
BACKGROUND: Partial nephrectomy is the treatment of choice for T1a tumours. The open approach is still the standard method. Robot-assisted laparoscopic surgery offers advantages that are applicable to partial nephrectomy, such as the use of the Firefly® system with near-infrared fluorescence. OBJECTIVE: To demonstrate the implementation of fluorescence in nephron-sparing surgery. CASE REPORT: This case concerned a 37-year-old female smoker, with obesity. The patient had a right kidney tumour measuring 31 mm, which was found using tomography. She therefore underwent robot-assisted laparoscopic partial nephrectomy, with a warm ischaemia time of 22 minutes and the use of fluorescence with the Firefly® system to guide the resection. There were no complications. The tumour was a pT1aN0M0 renal cell carcinoma, with negative margins. Robot-assisted renal laparoscopic surgery is employed for nephron-sparing surgery, with good oncological and functional results. The combination of the Firefly® technology and intraoperative ultrasound can more accurately delimit the extent of the lesion, increase the negative margins and decrease the ischaemia time. CONCLUSION: Near-infrared fluorescence in robot-assisted partial nephrectomy is useful for guiding the tumour resection and can potentially improve the oncological and functional results.
BACKGROUND: Partial nephrectomy is the treatment of choice for T1a tumours. The open approach is still the standard method. Robot-assisted laparoscopic surgery offers advantages that are applicable to partial nephrectomy, such as the use of the Firefly® system with near-infrared fluorescence. OBJECTIVE: To demonstrate the implementation of fluorescence in nephron-sparing surgery. CASE REPORT: This case concerned a 37-year-old female smoker, with obesity. The patient had a right kidney tumour measuring 31 mm, which was found using tomography. She therefore underwent robot-assisted laparoscopic partial nephrectomy, with a warm ischaemia time of 22 minutes and the use of fluorescence with the Firefly® system to guide the resection. There were no complications. The tumour was a pT1aN0M0 renal cell carcinoma, with negative margins. Robot-assisted renal laparoscopic surgery is employed for nephron-sparing surgery, with good oncological and functional results. The combination of the Firefly® technology and intraoperative ultrasound can more accurately delimit the extent of the lesion, increase the negative margins and decrease the ischaemia time. CONCLUSION: Near-infrared fluorescence in robot-assisted partial nephrectomy is useful for guiding the tumour resection and can potentially improve the oncological and functional results.
Authors: C Kouriefs; F Georgiades; M Michaelides; K Ioannides; A Kouriefs; P Grange Journal: Ann R Coll Surg Engl Date: 2019-06-03 Impact factor: 1.891
Authors: James Teh; Manisha Tripathi; Derek Reichel; Bien Sagong; Ricardo Montoya; Yi Zhang; Shawn Wagner; Rola Saouaf; Leland W K Chung; J Manuel Perez Journal: Nanotheranostics Date: 2021-01-01