Robotic‐Assisted Laparoscopic Partial Nephrectomy for a 7‐cm Mass in a Renal Allograft

Treatment options for a suspicious renal mass in a renal allograft include radical nephrectomy or nephron‐sparing surgery (NSS). To our knowledge robotic‐assisted laparoscopic partial nephrectomy (RPN) as treatment for a renal mass in a transplant kidney has not been previously reported. We report the case of RPN for a 7‐cm renal mass in a transplanted kidney. A 35‐year‐old female with reflux nephropathy received a living‐related donor kidney transplant in 1986. At 24 years after transplantation she had a 7‐cm Bosniak III cystic mass of the allograft detected on computerized tomography (CT) scan. Preoperative creatinine was 2.2 mg/dL with an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2. RPN was performed with bulldog clamping of the renal vessels, the graft was left in situ and immunosuppression was maintained postoperatively. Tumor diameter was 7.3 cm with a nephrometry score of 10a. Warm ischemia time (WIT) was 26.5 min. Estimated blood loss was 100 mL. There was no change between pre‐ and postoperative eGFR. There were no operative complications. Histology was papillary renal cell carcinoma type 1, nuclear grade 2. Margins were negative. RPN is a technically feasible treatment option for a suspicious renal mass in renal allografts. Robotic‐assisted laparoscopic partial nephrectomy in a renal allograft is feasible.