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Dr. Kutikov on retroperitoneoscopic partial nephrectomy for RCC

Commentary
Video

“Also, the technique lends itself really nicely to these, what we call posterior ball-valve tumors, which are these tumors that sit behind the renal hilum, behind the blood vessels on the posterior side of the kidney,” says Alexander Kutikov, MD, FACS.

In this video, Alexander Kutikov, MD, FACS, highlights the session, “Discussion: Partial nephrectomy for complex renal mass: retroperitoneal approach,” which took place at the 2024 American Urological Association Annual Meeting in San Antonio, Texas. Kutikov is the chair of urology at Fox Chase Cancer Center in Philadelphia, Pennsylvania.

Video Transcript:

This was a session that focused on the role of retroperitoneoscopic partial nephrectomy in management of renal cell carcinoma, and several surgeons shared their experiences in adopting this technique. We at Fox Chase have been using retroperitoneoscopic robotic partial–we call it retro partial–since 2012. There's a wealth of experience where we're able to offer minimally invasive partial nephrectomy to patients with what we call hostile abdomen, somebody who's had a lot of abdominal surgery and it would be highly risky to go transperineally into the abdomen due to adhesions, due to scar tissue. For somebody who's had a colostomy for instance, the bowel is right in the way, and [we] avoid all that and go retroperitoneoscopically, behind the bowel sac and resect that mass just as efficaciously as going transperineally, but doing it through a different approach. Also, the technique lends itself really nicely to these, what we call posterior ball-valve tumors, which are these tumors that sit behind the renal hilum, behind the blood vessels on the posterior side of the kidney. They're very difficult to access transperineally where you have to separate the adrenal and rotate the entire kidney in order to see that mass, whereas with retroperitoneoscopic access, you're looking at the kidney from the posterior surface and visualizing it in a way that is very difficult to do transperineally. There's a lot of disruption in that space now with new access through supine anterior approaches, and surgeons reviewed their experiences. It's an exciting field in the technical aspect of kidney surgery that's reviving some older techniques and bringing in new ones.

This transcription has been edited for clarity.

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