571
2375580226014562122178
Ces36887936014570127174
Urol38877936014578115180208
2018;41207936014562121176230253
22(4):43997936014561121152208239261
234–23746857936014562122183246301361417
VIDEO4696207016978121223301405
The774898013151110163
patient957898013160110141163215273304
had1281898013158107166
been1467898013160114167224
followed171589801312581104126183261312372
up2107898013158117
at224489801315081
his234589801315980119
catch‑248489801314998130175233266
ment6241048013190143201233
area881104801315183134182
facility1087104801313181130152174195228280
for1391104801313087119
two15341048013136117175
years.17331048013150101150181222241
Due20001048013171129182
to2206104801313692
an23221048013151109
increa‑2455104801312482131162213262295
sing624119801314162118177
size821119801314061104155
of996119801315886
the1105119801313087140
tumour1268119801313087175233290321
over16081198013158106157188
time1819119801313052140192
and20311198013149106165
an22161198013149106
increased2346119801311975123154205252292344403
risk62413480131325594139
of784134801315987
rupture896134801312988147180238269320
and12381348013150108167
major14261348013191139162219251
bleeding,1699134801316184136190251272330389408
a21281348013150
decision21991348013160113163184223245302361
was25811348013180129169
made6241498013190139198251
to899149801313692
use1016149801315998151
an11911498013152109
active13241498013152100137159208260
approach.16081498013151111171203260310358416435
The20681498013151111164
EAU22581498013151117181
guide‑24651498013159117138197250285
lines624164801312345102155196
on8471648013159117
the989164801313795148
treatment1161164801313870121169201291344402434
of1622164801315987
AML17371648013164150198
are1959164801315485137
rather2120164801313686118176229261
unequi‑24081648013159116170230287309342
vocal.6241798013151109160211234253
The9021798013161122177
criterion1104179801315891114149201234257316376
of1505179801316898
416281798013163
cm17111798013150142
AML18781798013174161211
that21141798013143103153186
has23251798013168119159
been25091798013171126181241
used624194801315897150210
for857194801312582114
years9901948013149100148179219
as1229194801315089
an13381948013150107
indication1469194801311976135157205254286308365423
criterion1912194801314980102135186217239296354
for2290194801312582113
surgical2423194801314197128186207255304326
management6242098013190138196244303356444497555586
is1234209801311958
no13122098013159117
longer1453209801311977135194247278
present1751209801316192144183236294325
in2100209801311977
the2200209801313188141
201823612098013154105152198
gui‑25802098013159116138170
delines.6242248013160113135157214267308327
The9752248013155115168
patient11712248013161111143165218276308
had15072248013159107167
successive16982248013145102150197247288327349398450
consultations21722248013153109167207263285318368400422480539578
at624239801315082
several730239801313891140191223273295
practices1046239801316092142191227249297348389
with14552398013180102136194
a16692398013150
proposal1740239801316193149209269309359381
to2145239801313187
remove2256239801312980169228276328
the2608239801313189142
whole6242548013178135192214265
affected908254801314977106157205240289348
kidney.1275254801314568126182234280293
One15862548013173130182
of1787254801315785
the1895254801312985137
options20512548013157116147169225282320
conside‑23892548013149103160198218276327361
red624269801313282141
was7842698013178126165
multi‑stage9682698013188144165197219251290323371429481
vasographic1468269801314997136192251281330388445466513
obliteration20002698013158116138159191241271320351372428485
of2504269801315885
the2613269801312985137
tumour,624284801313492181239297328341
however,9942848013159117195247296348379392
with14152848013179102135193
an16322848013155112
uncertain17732848013158116164215247284333355413
outcome.22142848013159117150196252342395412
At2654284801316596
our6242998013158115146
centre,789299801314999156187218268285
the1097299801313087139
patient12562998013160109140162213270301
was15772998013179127166
offered1763299801315886116167198248308
robotic‑assisted2094299801312884143201233255302328376415454475513547597656
resection,624314801313284124177227263285343401419
bearing10683148013161115163194217275334
in1426314801312482
mind15333148013190112169229
a17863148013151
high1862314801315981140197
risk208331480131345695140
of2249314801315886
nephrec‑23613148013159112171230261313362389
tomy.624329801313490180226239
The8873298013157116170
procedure1086329801316092149198249310367398449
was15653298013179129168
performed17633298013160114146178235267357410470
in2257329801312886
the2367329801313997150
right2541329801313860119177209
flank624344801312753102160205
position8513448013161120160181214237294353
with12263448013179102135193
the1443344801313290143
daVinci®16083448013160109161185242291313355
Xi1985344801316081
robotic2090344801313187147207239261309
surgical2423344801313996127185207255305327
system624359801314190131165216305
using955359801315998119177236
three1215359801313694125177231
robotic1470359801313491151210243265313
arms1807359801315283173212
(a2044359801313176
camera,21453598013150100189242274324342
bipo‑2513359801316183143202237
lar624374801312372103
instrument,751374801312683123157189247336389447479498
and12733748013152110170
monopolar14693748013190149207265326385408457488
scissors1981374801314492114153193251283324
or2332374801315890
needle24493748013159112166226248301
driver)624389801316090113161213244270
and9143898013149107166
one10993898013159117169
assistant1288389801315089128149188222271328360
port.16683898013160119150187206
Normally,18943898013170127159248297319340387400
we23143898013179131
do24653898013159117
not26023898013158116148
use624404801315896148
the795404801313087139
fourth957404801312480137167204260
robotic1241404801312883142200232253300
arm1560404801315080168
(prograsp)1752404801312584115170229260308347405430
during22014048013159115145167224282
resec‑2506404801312878118170218244
tion624419801313455112169
procedures.813419801316091147195245304360391442481500
The13324198013151110162
reason1517419801312979126165222280
for1820419801312581112
this1956419801312986107146
is2125419801311957
only22014198013158116137184
minimal24054198013189110167188275323345
benefit6244348013161115173226251278311
from959434801313366122212
its1195434801312660101
use1324434801315897150
for1499434801313289121
the1644434801313796149
surgeon18174348013144101132190243302360
as2201434801315493
well23224348013179131154176
as2522434801315393
an26394348013153111
effort624449801315382112169201238
to886449801313389
reduce999449801313082142199248299
the1322449801313290143
costs.14884498013149105145179221240
If1752449801312250
necessary,18254498013159112161212252292342373425438
its228744980131225597
role2408449801313187110163
can2593449801315099157
be6244648013161115
taken763464801313080125177234
over10184648013158107158190
by12284648013161108
the1360464801313088141
assistant1522464801315089129150189224273331363
port.19054648013161120152189207
After2133464801316492130180212
releasing2369464801312980103155203243264322381
adhesions6244798013150109167220260282340398437
in1085479801312381
the1190479801313492145
abdominal13594798013150110170228318340397446468
cavity,1851479801314999147170203254267
incision2142479801312381129151190211269328
of2494479801315887
the2605479801313492145
posterior6244948013161119159193244275298355387
peritoneum,10314948013160114145168201256314367424513531
and15824948013150107166
colon17684948013149105128185243
mobilization,20324948013189147207230251273316367398420478536554
the2610494801313087140
tumour624509801313493184244303335
and9845098013158117178
the11875098013143102156
adjacent13685098013159119142192241293352385
portion17785098013170130163201223282342
of2145509801316797
the22665098013143102157
kidney2447509801315680141200254303
were6245248013179132163214
exposed.8635248013156104164223263316377395
The12825248013155115168
hilum1477524801315981103160249
was17535248013180129169
dissected1949524801316082121161214263299350411
and,23845248013153111170188
du‑26005248013160117150
ring624539801313356114175
the8235398013143102155
course10035398013158114173205247301
of1328539801316896
resection1449539801314193134188238275298356416
and18895398013159117178
the20915398013143102156
placement2271539801317093143192244334388447479
of624554801315987
the7355548013142100153
first91255480131356192133168
layer1104554801313180126178210
of1338554801316694
suturing,14575548013149105139196228250308367385
the18665548013142100153
renal2044554801314091149198220
artery2288554801315890127178209261
was25815548013179129169
clamped.624569801314971120210269324384403
To10515698013160111
place1186569801316993142190242
stitches1452569801314984106140186244297338
around1814569801315890147205263323
the21615698013142100154
resection2339569801314192133186236272294352411
area,624584801315081133181199
including847584801312482131153210269291349408
the1279584801313593146
open14515848013158118172230
hollow17075848013159117140162220298
system,2029584801314291132167217307325
V‑LocTM2379584801315687137194243286371
sutures624599801314197131189220272312
were9585998013179131163214
used1194599801315998151212
in1430599801312178
three1532599801313290121173227
successive1783599801313995144190241281321343392444
steps,2251599801313973124184224243
while25165998013179138159181234
being6246148013160114135192251
anchored8956148013149106154211269301352411
with13266148013179101134191
non‑absorbable15376148013159116174207255314353411443502551610633685
Hem‑o-lok®22426148013169122210243303337361418463508
clips.62462980131497192151191210
Given854629801316890139190248
the1126629801313087140
price1286629801316092114162212
and15186298013150107166
excellent17046298013153101147198220242294351383
experience,21076298013153100160213245267319376425475492
we26186298013180131
exclusively2976898013153101147169226265286335387409457
use345389801315897150
non‑absorbable3623898013159117175208257316356414446506555615638690
clips43338980131497192152191
at454589801314981
our4646898013159116147
centre.481489801314999157188220271288
The29761048013151111164
suturing31641048013149106139197228251308368
of3556104801316695
the36751048013142100153
resection3852104801314092132185235271293351409
area4285104801315889141189
was45061048013179129169
thus46991048013142100157196
per‑49191048013169123154183
formed2976119801312986118207260320
in3320119801311977
two34211198013130111168
layers,3613119801312068115166198238257
with38901198013179102135193
the4107119801313088141
third4272119801313088109140198
suture4490119801314197131188219271
used4781119801315897150210
to5015119801313186
close2976134801314971129169222
the3222134801313492145
Gerota33911348013168122154210243292
fascia.3707134801312980119168190238257
We39881348013190140
have41521348013159108155207
very43831348013149101133184
good45911348013160118177237
expe‑48521348013153101161215250
rience2976149801313255108166214265
with32641498013179102135193
this3481149801313391113152
absorbable,36561498013150109149208240300350409433485502
self‑tightening4182149801314093116144174207230289346378429487509566626
suture4832149801314096130187218270
from2976164801313064123216
laparoscopic3217164801313384146198230289331382440503527577
procedures.38191648013171105164215268331391423477519540
It4384164801313368
enables44771648013164124175237261316358
rapid4861164801314294156179241
and29761798013150108167
safe3167179801314696124176
treatment3367179801313971122170202292345403435
of3830179801315987
the3941179801313997150
resection4115179801313789129182232268290347406
area4545179801315586137185
without47591798013180102135194252310343
a29761948013151
need30521948013169123179241
for3318194801313896130
knotting.34731948013156117177211248272331392412
The39101948013160122177
specimen41121948013150111166217240331386446
was45911948013181132173
extrac‑47891948013163112150183235285313
ted2976209801313485145
from3145209801312962119208
the3378209801313492145
body35472098013161120180229
using3800209801315898119177236
an40602098013150108
endobag41922098013154112171229289339399
through4615209801313492123180238297355
an49942098013150108
extended29762248013153101138189246306359419
port34192248013168128160197
site3640224801314870103154
at3818224801315890
the3932224801314199153
umbilicus.41092248013166155214237259280328386425445
A45852248013165
drain4674224801316798148170228
was49332248013180129169
passed29762398013161111150190243304
through3304239801313896127184242301359
the3687239801313997150
lateral3861239801312876108159191241263
port.41522398013161120152189208
The43852398013155115168
surgery45772398013146102134191244276328
was49332398013180129169
uneventful.29762548013159117170219271330362394453475494
Following34942548013159116140161220298321379439
surgery,39572548013150106138196249281333346
a43282548013158
48-hour44102548013162117151211270328360
resting4794254801314193133168190248308
period29762698013161115146169227287
was32952698013180130169
ordered,3488269801316799157210241293353371
with38912698013180103136194
the41092698013142100153
drain4287269801316799149171228
having45392698013167116164187244304
been48672698013169123176234
removed2976284801313284172231279330390
after3387284801314977115165197
2436042848013153101
hours.37252848013159117175206247266
The40122848013151110163
postoperative41952848013161120160194250310364395445477499548599
course48152848013149104162193234287
was29762998013179128168
completely31642998013149104193253275328361411434481
uneventful.36652998013159116169217269326358389447469487
As41722998013164106
of4298299801315887
now,44052998013158116194208
the4637299801313088140
patient47972998013161111142164216274305
is2976314801312361
one30573148013159117169
year32463148013148100148178
since3444314801314162119168218
surgery,3682314801314197128185238269320333
with40353148013179101134192
no42473148013158116
evidence43833148013153101124183235292341391
of4794314801315886
local4904314801311977126175197
recurrence2976329801313282129185215246296352398448
on34423298013157114
ultrasound.3575329801315778110140188227283339395452470
Follow‑up40633298013150105127147204280311369426
appointments45083298013149106165222243299329416467523554594
are2976344801315081133
scheduled3133344801313886144197257315337389450
at3604344801315082
yearly37073448013148100148179202250
intervals;3981344801312078109160192245295317356373
prospectively,4374344801316193150190249303352389411460512534582595
he49903448013159112
will29763598013179102124146
be31463598013160114
discharged3285359801315981120169227275307364417478
from3787359801312962118208
surveillance.4019359801314197128181233255277299347405454504522
Results:31263746013359113155213238272315336
The34853748013156115167
duration36803748013160116146195226247304361
of4069374801315986
surgery41783748013146101131188240270321
was45273748013180128167
12647173748013158102152
mins48973748013190110167205
(skin2976389801312966110133189
to3188389801313186
skin),3294389801314185108164188202
out35163898013159116148
of3684389801315886
which37893898013180137158205262
the4074389801313087139
procedure4233389801316192147196245305361391441
itself469738980131205293145166193
took4913389801313186144189
80mins,29764048013153104210229284321338
docking33314048013159114161204226281338
10mins,3686404801315398203223278315332
and40354048013149104161
undocking,42134048013157112169225272315337392449465
specimen4695404801314097148195215301352407
extraction29764198013153100135166215262297318375432
and34274198013150107165
wound36114198013180136193250308
suturing3938419801314196129185216237294352
2643094198013154103
mins.44314198013190111168206224
Blood4674419801315677134192251
loss4948419801312076115154
was29764348013178126164
50ml.31574348013153102207227244
The34184348013150108159
renal3599434801312776132179199
artery3815434801314979114163192242
was40744348013178126163
clamped4254434801314969116202259311369
for4645434801312378108
12mins.4770434801315396202222277314332
Angiomyolipoma31264498013164122182203261351397454477498558617706755
was39024498013179129168
confirmed40914498013149105163189215246336389449
by45614498013161108
histology.4689449801315981120154210233291351400413
The29764648013151111164
duration31644648013160117148198230253310369
of3557464801315887
hospital36684648013159117157216239272322344
stay4036464801314176125172
was42324648013179129169
544254648013153
days.45024648013160109155196216
Conclusion:31264796013363121181229254313355379438498519
Robotic‑assisted36654798013155113172230262284331358406445484505543577627687
resection4375479801312979119171220256277334392
of4787479801315886
renal4896479801312879136184206
tumours2976494801313492181239297328369
is3369494801312362
another34544948013150108166199257310341
advancement38194948013150109158208266315365454508566597
in4440494801312380
minimally45444948013190112169191280329351373421
in‑4989494801312280113
vasive2976509801315099139160210261
upper32585098013158118178232263
urinary3542509801315889112169218249301
tract3867509801313162112161197
surgery.4084509801314198129187240271323336
There44415098013151111164195247
has47085098013159108147
been48765098013160114168226
a29765248013150
major30545248013190139161219251
increase3329524801312784133164216264304357
in3710524801312784
the3818524801313896149
numbers39955248013159116205265319350391
of4414524801315987
patients45295248013161111143165217275307349
who49065248013179138196
can2976539801314999157
be31585398013169123
offered3305539801316797127179211262323
minimally36605398013191113171193282331353375424
invasive4108539801313189137187227248298350
surgery44825398013149106138196249281333
regar‑4839539801314193153203234263
ding2976554801316083141201
the32025548013142101155
size3382554801314971116168
of3574554801316897
the36955548013143102156
tumour,38755548013143101191250309341355
its4254554801313266108
position,43865548013170130171192226249307367385
or47965548013167100
safe49205548013150101129182
treatment2976569801313466117165197287340398430
of3430569801315887
the3541569801313492145
resection3710569801313284124177227263285343401
bed.41355698013161115175194
KEY29785984014770134206
WORDS321159840147105189260345408
Angiomyolipoma,31266148013165124185207266357404462486508568629720770788
robotic3939614801314199160220254276325
resection,4289614801314194135189239276299357417435
mini-in‑47576148013192114173195228252311345
vasiveness.29766298013150100139161210262320373413453472