OBJECTIVES: @entity8 protects against effects of @entity63 and permits longer pedicle clamp times during @entity1625 ( @entity1625 ). Our objective is to outline our step-by-step technique for intracorporeal renal cooling during @entity1625 . @entity1 AND MATERIALS: @entity1 selection was performed during preoperative clinic visit. Inclusion criteria included cases where @entity63 was estimated to be > 30 minutes during pre-operative assessment as determined by @entity1 with complex renal masses. Special equipment required for this procedure include an Ecolab Hush Slush machine (Microtek Medical Inc., Columbus, MS) a Mon-a-therm needle thermocouple device (Covidien, Mansfield, MA), and 6 modified 20 mL syringes. @entity1 are arranged in 60 degree modified @entity812 with the operative table flexed slightly at the level of the anterior superior iliac spine (ASIS). For introduction of temperature probe and ice slush, an additional 12mm trocar is placed along the mid-axillary line beneath the costal margin. Modified 10/20 cc syringes are prefilled with ice slush for instillation via accessary trocar. Perioperative and 6 month functional outcomes were compared to a cohort of @entity1 who underwent @entity1625 with @entity63 in a 2:1 matched fashion. Matching was performed based on preoperative @entity470 , @entity63 time and RENAL score. RESULTS: Strategies for successful intracorporeal renal cooling include: (1) placement of accessory port directly over the kidney. (2) Uniform ice consistency and modified syringes. (3) Sequential clamping of renal artery and vein. (4) Protection of the neighboring intestine with a laparoscopic sponge. (5) Complete mobilization of the kidney. Kidney temperature is monitored via needle thermocoupler device while core body temperature is concurrently monitored via esophageal probe in real time. Renal function was assessed by measuring serum @entity1011 , @entity470 and MAG-3 renal scan perioperatively and at 6-month follow up. In the separate matched analysis, cold @entity63 during @entity1625 was found to be associated with a 12.9% improvement in preservation of postoperative @entity470 . No difference was seen in either group at 6 month follow up. CONCLUSIONS: @entity1625 with intracorporeal @entity8 using ice slush is technically feasible and may improve post-operative renal function in the short-term. Our technique for intracorporeal hypotheramia is cost-effective, simple and highly reproducible. This article is protected by copyright. All rights reserved.

Robotic Partial Nephrectomy with Intracorporeal @entity8 Using Ice Slush: Step-by-step Technique and matched comparison to XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS', 'Patient'] @entity8 :: ('MESH:D007674', 'Disease') :: ['Renal hypothermia', 'renal hypothermia'] @entity1625 :: ('MESH:D004828', 'Disease') :: ['robotic partial nephrectomy', 'RPN'] @entity63 :: ('MESH:D007511', 'Disease') :: ['warm ischemia', 'ischemia'] @entity470 :: ('1956', 'Gene') :: ['eGFR'] @entity812 :: ('MESH:D021501', 'Disease') :: ['flank position'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine']
@entity63 :: (MESH:D007511,Disease) :: ['warm ischemia']
