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. 2025 Feb 11;25(1):25.
doi: 10.1186/s12894-025-01711-z.

Robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN): a prospective pilot study

Xu Shi #  1   2 , Yang Yu #  3 , Tianrun Ye #  1   4   5 , Gan Yu #  1   4 , Bin Xu  6 , Zheng Liu  1   4 , Ke Chen  1   4 , Wei Guan  1   4 , Shaogang Wang  7   8 , Heng Li  9   10
Affiliations

Robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN): a prospective pilot study

Xu Shi et al. BMC Urol. .

Abstract

Objective: To investigate a novel intracorporeal minimally invasive procedure for robot assisted laparoendoscopic single-site partial nephrectomy.

Methods: This study reported our technique and the outcomes of a minimally invasive approach for partial nephrectomy, specifically robotic laparoendoscopic single-site ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (LESS-HPN). A Freeport for LESS was inserted through a 4.5-5.0 cm skin incision. Instead of the traditional renal artery clamping technique, a Fogarty balloon catheter was used to occlude the renal artery or its branch. Tumor resection and wound suturing was then performed as routine steps.

Results: A total of 10 patients with T1 stage renal tumors underwent successful LESS-HPN from March to July 2023, with no conversions to renal artery clamping or additional ports. The mean operative time was 103.3 ± 11.1 min, including 21.0 ± 2.7 min of warm ischemia time. The mean estimated blood loss was 42.0 ± 22.5 ml. Tumors located posteriorly were associated with shorter operative time compared to those located anteriorly (p = 0.041). Occlusion of the main renal arteries, branch arteries, and accessory renal artery was achieved in 7, 2 and 1 cases, respectively. During a median follow-up of 10.5 months, no recurrence, metastasis, or death was observed. Limitations of this study include the small sample size, the absence of a control group, and the relatively short follow-up duration.

Conclusions: LESS-HPN has proven to be a safe and feasible alternative for achieving intracorporeal minimal invasiveness in patients with renal tumors.

Trial registration: Clinical trials were registered in September 4th, 2021, available at www.chictr.org.cn/ (ChiCTR2100050808). This article belongs to a selection of patients who were part of this clinical study.

Keywords: Hybrid partial nephrectomy; Laparoscopic ultrasound; Pilot study; Robotic laparoendoscopic single-site.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The ethics committee of Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology approved this study (No. 2020S138). Informed consent to participate was obtained from all of the participants in the study. Our study adhered to the Declaration of Helsinki. Consent for publication: All authors consent to publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) After a Freeport (Ningbo SensCure Biotechnology) was inserted. One 8-mm optic trocar and two 8-mm trocars for robotic instruments were placed at 12o’clock, 3o’clock, and 9o’clock direction, respectively, and two assistant trocars were placed at the same time. (B) da Vinci XI robot was docked
Fig. 2
Fig. 2
Through two assistant trocars, the monitoring area of the LUS probe can cover the large intra-abdominal vessels. (A) The LUS was swept to the long axis of iliac vessels through the assistant trocar caudal. (B) Through the assistant trocar caudal, LUS swept the long axis of the abdominal aorta. (C) Through the assistant trocar caudal, LUS swept the long axis of the abdominal aorta and renal artery orifice. (D) Through the assistant trocar cephalad, LUS swept to the long axis of the renal artery
See this image and copyright information in PMC

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