Editing Robotic Partial Nephrectomy (section)

== Equipment ==
*Ultrasound with doppler
*Sutures/staplers[https://www.jnjmedtech.com/sites/default/files/user_uploaded_assets/pdf_assets/2019-10/STRATAFIX-Knotless-Tissue-Control-Devices-Product-and-Procedure-Interactive-Brochure-044666-180807.pdf]
**Renorrhaphy
***2-0 Stratafix on CT-1 needle, cut to 23 cm (or 15 cm if smaller defect), with Hem-o-lok Weck clip in the loop perpendicular to the suture tail, x2
****23cm 2-0 Stratafix on CT-1: SXPP1B409
****15cm 2-0 Stratafix on CT-1: SXPP1B456
***3-0 monocryl on RB1 for collecting system or larger vessels
***Alternatively[https://pubmed.ncbi.nlm.nih.gov/21917095/]
****3-0 V-loc suture on a V-20 needle for the deep layer
****2-0 V-loc on a GS-21 needle for the outer capsular layer
**Closing
***0 Vicryl on UR6 x 2
***4-0 monocryl on PS-Z
***0 silk for drain
**Rescue sutures/staplers 
***If persistent bleeding from renorrhaphy
****0 Vicryl on CT-1 needle, cut to 10cm, tail on knots with two Hem-o-lok Weck clips before the knots, perpendicular to each other, x3
****2-0 Vicryl on CT-1 needle, cut to 10cm
***If vascular injury
****4-0 Prolene on RB1 (in case of vascular injury), cut to 10cm with Weck clip applied at the end[https://pmc.ncbi.nlm.nih.gov/articles/PMC6293683/]
*****A knot is tied at the end of the suture (see [https://pmc.ncbi.nlm.nih.gov/articles/PMC6293683/#F1 Figure]) and Weck clip is applied proximal to it; the thread is now again tied over the clip, this prevents slipping of the clip and helps it in sinching the opening in the vessel.
***If converting to radical nephrectomy
****Vascular staplers
****White, open staple height of 2.5mm, 45mm or 60mm depending on length of vessel[https://pmc.ncbi.nlm.nih.gov/articles/PMC8325431/]
*Bolster
**Surgicel, rolled, and tied in a roll using colorless suture (to contrast renorrhaphy sutures)
*Lapra-Ty and clip appliers
*Hem-O-Lock clips and applier
*Specimen Retrieval Pouch
**Endo Catch™ Gold device 10 mm
***Volume 220mL
*If retroperitoneal
**S-curve retractors
**Tonsil clamp
**Spacemaker dissection balloon
***Kidney shaped
****If using Medtronic Spacemaker Dissection Balloon PDB2 product, the maximum number of pumps is 50. However, the actual number of pumps required to dissect the space will vary from patient to patient.[https://www.esutures.com/product/0-in-date/30-covidien-autosuture/466-hernia-repair/8001-medtronic-pdb-spacemaker-dissection-balloon-kidney-shape-OMS-PDBS2/]
**12 mm blunt tip balloon trocar[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382714/]
***Consists of a blunt obturator and a valve body/cannula assembly. 
****The valve body/cannula assembly contains an internal flapper valve and seal to prevent gas leakage when instruments are inserted or withdrawn. The Blunt Tip Trocar includes built-in converters to allow insertion of instruments of various diameters. In addition, the device has an external one-way valve for gas insufflation.
***To minimize leakage and secure the trocar, the distal end of the sleeve has a balloon which is complemented by the proximal foam sponge/collar assembly. A syringe is provided for inflation/deflation of the balloon.