Practical Strategies to Predict, Avoid and Manage the Complications of Robotic-Assisted Partial Nephrectomy
Abstract
1. Introduction
2. Preoperative Considerations
2.1. Patient Selection and Planning
2.1.1. Imaging
- Renal vascular anatomy (number, location, branching);
- Tumour size, location (polar location, depth, relationship to hilum and collecting system), and margin/boundary (well defined, irregular, vascular invasion);
- Relationship of the kidney and the tumour to surrounding structures;
- Patient anatomical variations—spinal abnormalities, aberrant abdominal vasculature (such as superior mesenteric artery origin).
2.1.2. Three Dimensional (3D) Models
2.1.3. Nephrometry Scores
2.1.4. Transperitoneal Versus Retroperitoneal Approach
2.1.5. Prediction of Postoperative Complications
3. Procedural Considerations
3.1. Positioning
3.2. Kidney Exposure Complications
3.2.1. Vascular
3.2.2. Bowel
3.2.3. Spleen
3.2.4. Pleura
3.2.5. Pancreas
3.2.6. Liver
3.2.7. Lymphatic
4. Specific Complications to Robotic-Assisted Partial Nephrectomy
4.1. Bleeding
4.2. Urine Leak
4.3. Positive Surgical Margin
4.4. Renal Function
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Type of Injury | n | % |
---|---|---|
Hollow viscous | 2 | 0.3 |
Pleura | 1 | 0.2 |
Vascular | 2 | 0.3 |
Adjacent organ | 4 | 0.7 |
Intra-operative transfusion | 4 | 0.7 |
Reference | Design, Location | Number of Patients | Haemorrhage | Pseudoaneurysm/ AVF | Urine Leak | PSM |
---|---|---|---|---|---|---|
Bic 2023 [46] | Multicentre case series, France | 1900 | 88 (4.6) | 3 (0.16) | 7 (0.37) | NR |
Bravi 2021 [47] | Multicentre case series, Italy | 789 | 17 (2.2) | NR | 1 (0.13) | 41 (5) |
Peyronnet 2016 [48] | Multicentre case series, France | 937 | 64 (6.9) | NR | 19 (2) | 48 (5.2) |
Tan 2018 [49] | Multicentre case series, Australia | 145 | 4 (2.8) | 3 (2) | NR | 5 (3.5) |
Grimm 2025 [50] | Prospective RCT, Germany | 123 | 2 (2) | 3 (3) | 4 (4) | 11 (10) |
Wang 2017 [51] | Multicentre case series, China | 190 | 6 (3.2) | 2 (1) | 4 (2.1) | 3 (1.6) |
Furukawa 2020 [52] | Multicentre case series, Japan | 804 | NR | 33 (4.1) | 2 (0.2) | 8 (1.1) |
Connor 2020 [53] | Single-centre case series, USA | 395 | NR | 9 (2.3) | 1 (0.25) | NR |
Ramirez 2016 [37] | Single centre case series, USA | 545 | 23 (4.2) | 0 (0) | 1 (0.8) | NR |
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Shepherd, A.R.H.; Challacombe, B.J. Practical Strategies to Predict, Avoid and Manage the Complications of Robotic-Assisted Partial Nephrectomy. Complications 2025, 2, 21. https://doi.org/10.3390/complications2030021
Shepherd ARH, Challacombe BJ. Practical Strategies to Predict, Avoid and Manage the Complications of Robotic-Assisted Partial Nephrectomy. Complications. 2025; 2(3):21. https://doi.org/10.3390/complications2030021
Chicago/Turabian StyleShepherd, Andrew R. H., and Benjamin J. Challacombe. 2025. "Practical Strategies to Predict, Avoid and Manage the Complications of Robotic-Assisted Partial Nephrectomy" Complications 2, no. 3: 21. https://doi.org/10.3390/complications2030021
APA StyleShepherd, A. R. H., & Challacombe, B. J. (2025). Practical Strategies to Predict, Avoid and Manage the Complications of Robotic-Assisted Partial Nephrectomy. Complications, 2(3), 21. https://doi.org/10.3390/complications2030021