Robotic-Assisted Nephrectomy Minimizes Warm Ischemia Time

An analysis conducted by researchers at NewYork-Presbyterian Hospital/Columbia University Medical Center stated that a revolutionary procedure that simplifies a robotic partial nephrectomy, a surgical procedure of removing a kidney tumor, can bring 25% reduction in the critical time the kidney is without blood flow, also called as warm ischemia time (WIT).

The procedure, “first assistant sparing technique” (F.A.S.T) provides results similar to that of a standard robotic partial nephrectomy surgery rapidly and efficiently, despite the size, complexity or location of tumor. The procedure has been reported in the Journal of Endourology published in June. The F.A.S.T. integrates conventional steps within the robotic process.

The study results were determined following a six-month long comparative analysis of F.A.S.T against standard robotic techniques involving 44 patients who experienced robotic partial nephrectomy. F.A.S.T. showed efficiency as much as a standard robotic approach. Using this procedure, the experts can achieve complete tumor removal without any positive surgical margins.

According to Dr. Ketan K. Badani, chief of robotic and minimally invasive surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, a partial nephrectomy removes tumor, protecting the kidney. During the procedure, the kidney needs temporary termination of blood flow. As per the rule of thumb, 30 minutes is the permissible time for temporary stopping of blood flow, which when exceeded can cause irreversible damage. The kidney function will experience cumulative effect every minute when blood flow to the kidney is blocked, according to studies.

F.A.S.T. combines robotic process with a series of conventional steps performed by surgical assistants such as ultrasound, passing of needles, stitches, clamping to cut off and restore blood flow to the kidney, thereby reducing critical WIT minutes.

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