We present the case of a patient with an incidental diagnosis of a complex right renal cyst managed with robot-assisted laparoscopic partial nephrectomy using hydrodissection for tumor resection.
The surgery was performed with 2 robotic arms. Four ports were routinely placed, the colon was mobilized, and the tumor was dissected. Tumor delimitation was performed with laparoscopic ultrasound, and the renal artery was clamped. We then performed the tumor resection assisted by a laparoscopic water-jet applicator, operated by the assistant through an auxiliary port. The renal parenchyma was reconstructed in 2 planes, without knots, and the arterial clamp was withdrawn at 23 min. The resection margins were negative.
The use of water-jet technology to assist with the renal tumor resection during minimally invasive nephron-sparing surgery facilitates the dissection, making it more fluid and atraumatic. Simultaneously, the technique provides a clean surgical field, which improves visibility. This procedure can help decrease ischemia times, thereby positively affecting the patient's evolution without compromising the oncological results.