Richard E. Link, MD, PhD, presented “Alternative Access Approaches for Less-invasive Nephron-sparing Surgery” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.

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How to cite: Link, Richard E. Alternative Access Approaches for Less-invasive Nephron-sparing Surgery.” September 22, 2024. Accessed Dec 2024. https://grandroundsinurology.com/alternative-access-approaches-for-less-invasive-nephron-sparing-surgery/

Alternative Access Approaches for Less-invasive Nephron-sparing Surgery – Summary

Richard E. Link, MD, PhD, explores advances in robotic kidney surgery, focusing on nephron-sparing approaches and alternative access strategies, specifically through the low anterior access with the SP (single-port) robot. Historically, while only about 10% of nephron-sparing surgeries employed the retroperitoneal technique due to challenges in positioning and multiport access, the advent of the SP robot has significantly altered this landscape.

In this 18-minute presentation, Dr. Link shares the low anterior access technique, which offers a versatile approach to addressing tumors located anywhere in the kidney—anterior, posterior, medial, or lateral—while minimizing the need for complex patient positioning. The primary advantage of this approach is reduced postoperative complications, faster recovery, and less pain, which are of greater importance to patients.

Data from Link’s practice indicate a marked increase in adopting retroperitoneal access using the SP robot, rising from 15% to 80% over recent years. This shift has led to a significant reduction in hospital stays and a streamlined surgical process, resulting in shorter operative times. Dr. Link shares video of the process and includes practical tips for optimizing this approach.

 

About The 28th Annual Innovations in Urologic Practice:

Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.

For further educational activities from this conference, visit our collection page.