The role of nephron-sparing robotic surgery in the management of renal malignancy

Abstract

Robotic-assisted partial nephrectomy is an emerging technique for the treatment of renal malignancy. Our aim is to review the initial reported experience with robotic partial nephrectomy, evaluating techniques, early outcomes, and potential advantages of the robotic approach over the traditional laparoscopic approach. Early experience with robotic partial nephrectomy demonstrates good oncologic outcomes. Other parameters, such as operative time, blood loss, postoperative renal function, and hospital stay, appear to be at least equivalent to laparoscopic partial nephrectomy. New techniques, including refined methods for renorrhaphy, have also been introduced which aim to simplify critical portions of the procedure, although vascular clamping still remains a challenging aspect of the procedure. The learning curve appears to be slight, even for surgeons without extensive laparoscopic experience. Although long-term outcome data is presently lacking, the early experience with robotic partial nephrectomy shows promise. The technique should continue to evolve as it gains acceptance as an alternative to the traditional laparoscopic approach.