Mayo stand and back table instruments for Robotic Partial Nephrectomy surgery setup

Clamping & Occluding

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  Curved Hemostat

Cutting & Dissecting

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  #3 Knife Handle

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  Straight Mayo Scissor

Grasping & Holding

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  Adson Forceps

Misc

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  Camera Cord

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  Laparoscope

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  Light Cord

Suctioning

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  Suction Irrigator

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Robotic Partial Nephrectomy

Da Vinci instruments will be needed for this surgery since it is robotic. Make sure to always have regular laparoscopic instruments close by in case the surgeons decides to not do the case robotically.

The robot needs to be draped before the surgery begins, and all staff should be aware of how the robot works.

The surgeon will begin with a regular camera, light cord, and scope. They will use a #3 knife handle to make their incisions with either a 15 or an 11 blade. They will insert the robotic trocars that are kept in the robot sets. You will need to assemble these.

Once the surgeon is happy with their port placements, they will break scrub and run the robot. At some hospitals the surgical tech will be the only one left at the sterile field to insert and swap instruments. Other times there will be either a second tech, a residents, fellow, or another attending.

The laparoscope will be swapped out for the robotic scope.

The robot will be docked over the patient’s shoulder during the case.

First, the bowel will be mobilized using blunt dissection. Graspers, possibly scissors, and cautery will be used for this step. Any attachments on the liver will also be dissected. The ureters will be identified and lifted, making an area to then find the renal hilum to dissect. A clip applier may be used often depending on what bleeders there may be.

Laparoscopic bulldog clamps may be used to clamp the renal hilum. Arteries and veins will be clamped, and the tumor will be excised, and a robotic needle driver with suture loaded may be used to help reconstruct.

After the tumor has been excised, the clamps can be taken off, and a bag will be placed in the abdomen to take out the specimen. After the specimen has been removed, hemostasis is ensured, and close with a mayo-hegar needle driver, straight mayo scissors, and adsons may begin.