Removing perirenal adipose overlying tumor & clamping of renal artery A. Kutikov, Randall Lee, Benjamin Ristau

Removing perirenal adipose overlying tumor & clamping of renal artery

• Defatting of the kidney and exposure of the renal mass proceeds similarly to transperitoneal partial nephrectomy.  Some surgeons elect to remove retroperitoneal fat in order to create more space.  Yet, overzealous manipulation with the 4th robotic arm and unnecessary mobilization of the renal fat can compromise visualization.  As such, extent of dissection needs to be judiciously calibrated.  
• Bulldog clamp is carefully applied to the renal artery once the surgeon is ready to resect the tumor.