The use of the fourth arm and intraoperative ultrasound in robotic partial nephrectomy

Roberto Nucciotti1, Fabio Massimo Costantini1, Francesco Mengoni1, Fabrizio Viggiani1, Alessandro Bragaglia1, Giandomenico Passavanti1, Irene Farnetani1, Valerio Pizzuti1
  • 1 Ospedale Misericordia, U.O. Urologia (Grosseto)


The partial nephrectomy is the procedure in which the robotic approach is the best indication. The use of the fourth arm is particularly suitable in order to expose the anatomical structures and to leave the assistant the only task of having to suck. Many surgeons prefer not to use it to the risk of conflict but with a few simple precautions you can enjoy all the advantages of the fourth arm.
The video also shows the usefulness of intraoperative ultrasound in order to directly evaluate the surgical resection margins.