Abstract

  Robot-assisted laparoscopic partial nephrectomy (RAPN) is covered by insurance for renal cancer in Japan, and a dramatic increase in cases is expected. With regard to surgical indication, it is estimated that there are many facilities where the experience is limited initially to T1a or relatively easy cases, however the indication is gradually expanded and T1b or more or surgery difficulties may be expected. On the other hand, for RANP cases for single renal cases and cases with already impaired renal function, so-called imperative cases, consideration must be given to surgical indication and preoperative evaluation, surgical procedure, and perioperative patient care. In this paper, based on the experience of our institute, we give an outline for imperative case.