Intracorporeal Cooling and Extraction Technique of Robotic Partial Nephrectomy

Abstract Introduction: The ability to ice the kidney and grossly evaluate the excised tumor during open partial nephrectomy has been difficult to replicate in a reliable fashion using a minimally invasive approach. We previously described a robotic partial nephrectomy (RPN) technique with intracorporeal cooling and extraction (I.C.E.) for cold ischemia and intraoperative tumor assessment.1 We present a video of our I.C.E. technique.2 Recent evidence suggests a potential benefit of cold ischemia for preserving renal function.3,4 The total run time for our video is 8 minutes 2 seconds. Materials and Methods: A total of eight patients underwent the I.C.E. modification of RPN by transperitoneal (n=6) and retroperitoneal (n=2) approaches. A GelPOINT® access port (Applied Medical) was used for the camera and assistant ports. After hilar clamping, modified syringes loaded with ice slush were introduced through the GelPOINT and ice slush was applied over the kidney surface. The excised tumor was immediately extra...