METHOD OF ORGAN-PRESERVING ROBOT-ASSISTED INTRACORPORAL KIDNEY RESECTION USING ISOLATED PHARMACO-COLD ISCHEMIA WITH CARDIOPLEGIC SOLUTION Russian patent published in 2024 - IPC A61B17/94 A61K31/405 A61K31/417 A61K33/06 A61K9/08 A61M5/20 A61P43/00 

FIELD: medicine; urology; surgery; oncology.

SUBSTANCE: following is performed: ports for carrying out robotic manipulators are installed, transperitoneal access to the kidney is made by opening the retroperitoneal space along the Toldi line, the kidney is mobilized, the kidney tumor is identified, the kidney is isolated along the renal vein, renal artery and ureter, the kidney is rotated, vascular clamps are installed like a “bulldog” on the branches of the renal artery and vein, followed by resection of the kidney tumor, removal of clamps, followed by drainage of the retroperitoneal space and restoration of the integrity of the retroperitoneal space. Before tumor resection, pharmaco-cold ischemia of the kidney is performed using Custodiol cardioplegic solution. For this purpose, simultaneously with the installation of ports for carrying out robotic manipulators, an additional port for carrying out an endoscopic injector is installed. For pharmaco-cold ischemia of the kidney, a venotonic opening is formed in the wall of the renal vein distal to the place of its clamping. The blood is aspirated, the renal artery is punctured with an endoscopic injector distal to the clamping site, and perfused with Custodiol cardioplegic solution. After removing the tumor within healthy tissue and removing the vascular clamp from the renal artery and kidney hyperemia, the residual volume of the cardioplegic solution is aspirated from the blood through the renal vein. Then the hole in the renal vein is sutured, and the vascular clamp is removed from the renal vein.

EFFECT: method provides the possibility of long-term, up to 180 minutes, disconnection of the kidney from the main blood flow during robotic interventions on it while reducing intraoperative and postoperative risks, can significantly reduce the trauma of the operation and the amount of blood loss, and allows the patient to be quickly activated in the postoperative period on the 1st day after surgery, remove the safety drainage and urethral catheter at an earlier date, and discharge the patient 4–5 days after the surgery.

1 cl, 3 dwg, 3 ex