Back to 2026 Abstracts
Nephro-Sparing Approach for Pediatric Wilms Tumors: Robotic Assisted Laparoscopic Partial Nephrectomy
Christopher Wanderling, MD, Ashley Li, MD, Kaela Mali, BS, Mark Ninomiya, MD, David Diamond, Md, Jimena Cubillos, MD, Guan Wu, Md.
University of Rochester Medical Center, Rochester, NY, USA.
BACKGROUND: Wilms’ tumor remains the most common pediatric renal malignancy and one of the most frequently diagnosed childhood cancers. Contemporary management prioritizes durable oncologic control while preserving long-term renal function. While radical nephrectomy remains the standard for unilateral disease, select patients may benefit from nephron-sparing surgical (NSS) approaches, such as those with a solitary kidney. Majority of approaches in NSS are done open or laparoscopic, but herein, we present a case of robot-assisted partial nephrectomy for NSS.
METHODS: The patient was a 3-year-old female who presented after a fall with abdominal pain, nausea, and vomiting. During her evaluation, she was found to have a progressive drop in her hematocrit, and CT was obtained, showing a large left cystic and solid renal mass with associated perinephric fluid concerning for active hemorrhage. A 1.5cm right-sided lower pole tumor was also identified. Given her acute blood loss anemia, she underwent emergent nephrectomy and adrenalectomy. Subsequent workup found the patient to have a Stage V Wilms’ tumor. After discussion with multidisciplinary pediatric oncology board, the patient underwent chemoradiation therapy followed by robot-assisted partial right nephrectomy. After dissection of the hilum was achieved, an on-clamp tumor enucleation was performed followed by renorrhaphy. There was minimal blood loss, and the patient tolerated the surgery well with an uncomplicated post-operative hospital course.
RESULTS: This video demonstrates the use of a robotic approach in a patient with a Wilms’ tumor. Pathology resulted in a 1.2cm Wilms’ tumor with negative margins and no tumor extension. She received planned adjuvant chemotherapy, and interval surveillance imaging showed no additional disease requiring further intervention.
CONCLUSIONS – Robot-assisted laparoscopic partial nephrectomy should be considered as a nephron-sparing option in patients with Wilms’ tumors and history of solitary kidney.
Back to 2026 Abstracts
