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Tumour abutted the resection margin in one case of a central 5.5 cm mass which demonstrated renal sinus and vascular invasion on frozen section. A completion nephrectomy was then immediately performed given these high-risk features and also given that the contra-lateral kidney and pre-operative renal function were normal. There was no residual tumour in the remaining kidney. One patient had a grade 1 Clavien-Dindo classification who had self-resolved neuralgic pain. No cases were converted to an open operation. Our study is compared with international data in Table 4. Table 2. Perioperative data. Pre-op eGFR Median (Range) [http://en.wikipedia.org/wiki/Isotretinoin Isotretinoin] 74 ml/min/1.73 m 2 (53�C90) Day 1 Post-op eGFR Median (Range) 63 ml/min/1.73 m 2 (39�C90) [p [http://www.selleckchem.com/products/gdc-0068.html selleck chemicals] pain self resolved View it in a separate window eGFR: estimated glomerular filtration rate. [p value] compared with pre-op. Table 3. Histopathology. Clear Cell RCC 9 Papillary RCC 3 AML 1 Eosinophilic variant clear cell RCC 3 Positive Margins 1 View it in a separate window RCC: Renal cell carcinoma; AML: Angiomyolipoma Table 4. Study comparison. Median (Range) Current Study (n=16) San Francisco et al. (n=12) Operative time 230 mins (180�C280) 227 mins (176�C315) WIT 15 mins (8�C25) 16 mins (11�C25) Blood loss 100 mL (50�C1000) 150 mL (50�C500) Length of stay 2 days (2�C6) 2 days (2�C7) Positive margins 1 (6.25%) 1 (8%) View it in a separate window WIT: Warm ischaemia time Raw data Pre-, post- and perioperative data for patients undergoing robot-assisted laparoscopic partial nephrectomy 23. Click here for additional data file.(972 bytes, tgz) Discussion RAPN is an effective surgical alternative in NSS in which [http://www.selleckchem.com/products/incb28060.html INCB28060 chemical structure] the ultimate goal is to achieve the ��trifecta�� of a negative cancer margin, minimal decrease in renal function and an absence of complications 14. The use of robotic technology can assist in achieving these outcomes and in particular, minimise renal dysfunction by reducing WIT. Laparoscopic partial nephrectomy not only has a steep learning curve to achieve acceptable WIT but also requires skills that are challenged by its technical difficulties, including the use of instruments that have limited degrees-of-freedom. The robot application in PN allows a three-dimensional vision with magnification and instrument arms that are versatile with its EndoWrist ? technology, providing increased angle and maneuverability for tumour excision and repair of the renal defect 15. Various methods have been employed in the past to lessen the ischaemic injury. Intra-arterial hypothermic perfusion was used in early series of LPN 12 as was intra-corporeal placement of ice slush 13.