Robot-assisted partial nephrectomy utilizing a hybrid-port technique.

Robot-assisted laparoscopic partial nephrectomy is increasingly being favored for treatment of small renal cortical neoplasms. The technique utilized varies based upon the institution and surgeon experience and several modifications have been proposed. We choose to utilize the fourth robotic arm as well as the Satinsky vascular clamp for these cases. Previously, we would utilize the fourth arm through a robotic port until the hilum was dissected, then replace the trocar with a flexible trocar for the Satinski clamp. We now utilize a hybrid-port technique where we establish placement of the flexible trocar and pass a robotic trocar through this to begin with the fourth arm in use. We then remove the fourth arm and the trocar after the hilum is dissected to place the Satinski clamp. The technique and description will be discussed.