ORLANDO, FL (UroToday) - Dr. Peter Pinto discussed ablative therapies and evolving treatments for the small renal mass. He addressed laparoscopic partial nephrectomy. The learning curve is steep and requires technical expertise. However, at centers of excellence it is a good technique. If the partial nephrectomy by a surgeon is best done open, he advocated that approach. The data at large centers support lap partial nephrectomy with less blood loss and OR time. The renal function is not adversely affected. The 3-year disease free rate is 96%.

He showed the University of Michigan data that for small renal masses, urologists nationally still perform radical nephrectomy and not partial nephrectomy. In the future, robotic partial nephrectomy will make the skill transfer easier for urologists. He cited a feasibility study in 8 patients that underwent robotic partial nephrectomy that suggested it to be safe with an efficacious outcome. He showed a video of a robotic partial nephrectomy. Visualization was excellent and range of motion of the surgical instruments good. The robotic approach permitted facile application of hilar clamps as well as suturing. This emerging technique makes impact the practice of urologists to perform a lap nephrectomy instead of a partial nephrectomy.

Presented by Peter Pinto, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday Contributing Editor Christopher P. Evans, MD, FACS

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