 So, we will start this session on surgical treatment of locally advanced localized disease and locally advanced RCC. May I have my introduction slide, please? My introduction slide, please. How many surgeons have we got in the room? Quite a few. Great. May I have my slides? You just give us two minutes, please. We're just going to do your slides. Okay. Thank you. No, it's not this one. It's the other slide. It's introduction slide. This is the clinical cases at the end of the session. You have two set of slides. One is the introduction and the other is the clinical case. No? It's again, it's clinical case. So basically it was an introduction for seeing always in the audience surgeon, medical oncologist, nurses, pathologists, biologists, all over. And I wanted to show you some summary slide of clinical cases for having a vote before the presentation and a vote after. So we will go to the presentation. It doesn't work. No, it doesn't matter. Let's go on the first presentation. Okay. We're covering four subjects this afternoon in the surgical series. The first is a debate about robotics. Does it have to be robotics if you're doing partial refractomy? The second is on ablation. The third on the surgery for advanced disease and then Jean-Jacques clinical cases to close the surgical session. Without further ado then, I'd like to ask Christophe Fassan from Paris to come and make the case for everybody having a robot. Should I have a robot, partial refractomy? First off, make me walk on. May I have my slides, please? That's the most difficult step. So I must first thank the organizing committee for this invitation and to give me the opportunity to speak about this very exciting topic about robotic surgery. They completely changed the field of surgery in neurology and I think especially for the upper track. So can I have my slides? Okay. Okay. Thank you. If it works. So I think that first we will both admit the concept that partial refractomy must always remain the only goal of this surgery. And the way to do it will remain optional, of course. So for those who are not surgeons, this is what robotic surgery looks like. The surgeon is sitting in a console, he's moving the instrument with joystick. He has a 3D view so he's completely merged inside the patients. And on the other side, you have the patients with laparoscopic tubes that are moved by the surgeon. So in my institution, we have a 10-year experience on robotic surgery. We do right now for more than 400 cases a year. And kidney surgery represents close to 150 high cases per year concerning mostly partial nephrectomy but also some kind of very large radical nephrectomy or patients for a living donor nephrectomy. So which tumor will be accessible for this kind of surgery? Of course, the small localized peripheral tumor. But also some larger tumor that you can see here on the solitary kidney that will be done with a selective clamping or this very posterior tumor. And I like to do it in this case, laparoscopically, so you don't have to open the peritoneum. So this is how the surgery looks like very quickly. You have the external view and then we dissect the heel of the kidney so we can clamp the artery and the vein. And as soon as it is clamped, you can just remove the tumor. In this case, it was a 4.5 centimeter tumor. Then as soon as the tumor is, you can open, even open the cavity, in this case. As soon as the tumor is removed, it's placed in a small bag. And then you can just repair the kidney to make hemostasis and to avoid any perspirative bleeding, which of course sometimes can occur. So as soon as the kidney is repaired, you will be declaim the kidney and be sure the hemostasis is correct. So this was our last data from last year. So as you see, I do both trans and retroparitoneal approach. If we compare tumor a little bit larger for transpiritoneal and smaller for a retrop, but we can go up to 8 centimeter depending on the patient. We always say that robotic surgery is longer. In fact, it's most of the time less than two hours and it's even quicker with the lomboscopic approach. With a very controlled warm ischemia, which is most of the time less than 15 minutes. And the hospital state, and we will see a little bit later, and that is the major advantage of robotic surgery is the hospital state. We've also a very well controlled oncological outcome with a positive margin of 1.6%. So we have, of course, observed a few complications. Most of those will be hematoma, postoperative hematomas. Most of them were just under surveillance, few transfusions, and just one patient needed embolization of this bleeding. We also had one patient with a urinoma. So in our institution, we did compare the robotic parachial nephrectomy and the open parachial nephrectomy. So on 100 consecutive patients, we saw that the mean tumor size were not different between those two groups. And the only difference were the high complexity score, which was a little bit higher in the open surgery group. So we compared the operative term, of course, which is almost the same between open and robotic parachial nephrectomy. Clamping time, 17.5 minutes. That was the first part of the experience. So it's why it's a little bit higher than the previous data that I've shown. So I think that right now, we go even faster with the robot but then in open surgery. So the main difference was the length of stay, which is 3.8 days for robotic surgery and 6.8 days in open surgery. So the robotic parachial nephrectomy was better than open parachial nephrectomy in terms of blood loss and hospital stay. And it has the same rate of complication, warm ischemia and impact on renal function. So we could say that robotic parachial nephrectomy is only accessible for small tumors. So in a survey in France, around 6 French academic centers between 2007 and 2011, we recorded 220 robotic parachial nephrectomy and 54 patients had a tumor over 4 cm. With intermediate and most of the patients had intermediate and high risk scorn nephrectomy. So as you can see, the warm ischemia is a little bit higher but we still have quite a normal operative time. It's a little bit higher also. It's turning around 3 hours and the warm ischemia is 23 minutes. Complication rates, of course, if you have a larger tumor, you must see some more complications. So we had 9 complications over 54 patients. Only 3 positive margins which makes the outcome, oncological outcomes quite similar to the open literature. So why robotic parachial nephrectomy is all gold standard at least in our department? Just because also we completely switch from open to parachial nephrectomy. This year, we are expecting to do more than 100 robotic parachels and only probably 15% of those will be open. We did 50 robotic parachial nephrectomy during the first month of this year and only 6 were open. So why also we choose to switch completely to robotic parachels? Because we've seen the same oncological outcomes. Short-term hospitals stay with a quicker recovery for the patient and less morbidity. When you see an open scar and you have complication of that open scar, most of the patients don't want to go for that kind of surgery anymore. But new front sparing surgery remains, I think, a challenging surgery, even open and of course it is robotically also. So I think it's the kind of surgery that should be done in a referring center with, I think, a high volume patient. Thank you. Thank you, Christo.