Awake Da Vinci robotic partial nephrectomy: First case report ever in a situation of need

We report a unique case of a robotic partial nephrectomy performed under continuous spinal anesthesia (CSA). A 63-year-old woman, active smoker with mild obesity and previous right pneumonectomy, was diagnosed with a growing 5.5-cm renal right cystic tumor. Being at high risk for general anesthesia,...

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Bibliographic Details
Published inUrology case reports Vol. 42; p. 102008
Main Authors Gontero, Paolo, Oderda, Marco, Calleris, Giorgio, Allasia, Marco, Balagna, Roberto, Gobbi, Fabio
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2022
Elsevier
Subjects
Awake
Case report
Laparoscopy
Oncology
Renal cancer
Robotic
Spinal anesthesia
Case report
Laparoscopy
Renal cancer
Robotic
Awake
Spinal anesthesia
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Summary:We report a unique case of a robotic partial nephrectomy performed under continuous spinal anesthesia (CSA). A 63-year-old woman, active smoker with mild obesity and previous right pneumonectomy, was diagnosed with a growing 5.5-cm renal right cystic tumor. Being at high risk for general anesthesia, a loco-regional approach was indicated. Therefore, after multidisciplinary discussion, a robotic-assisted partial nephrectomy under CSA was considered mandatory. After T4-T5 sensory and motor block, retroperitoneoscopic robot-assisted surgery was successfully performed. Postoperative period was uneventful, with optimal pain control. This unique case demonstrates the feasibility of robotic surgery under CSA, for imperative indications. •Regional anesthesia is an alternative to general anesthesia in selected patients.•General anesthesia is typically required for robotic surgeries, to avoid movements.•We report the first case of a robotic partial nephrectomy under spinal anesthesia.•Regional anesthesia can be an option for robotic surgery in selected unfit patients.
ISSN:2214-4420
2214-4420
DOI:10.1016/j.eucr.2022.102008