Benefits of Robotic Assisted vs. Traditional Laparoscopic Partial Nephrectomy: A Single Surgeon Comparative Study

Abstract

Purpose: The current study aims to compare peri-operative and post-operative outcomes between robotic assisted vs. laparoscopic partial nephrectomy. Multiple reviews of the current literature have detailed the lack of single surgeon studies in this domain. To limit inter-operator bias, we utilise a single surgeon experienced in both approaches to reduce this bias seen in other multi-centre studies. Methods and Materials: We retrospectively compared patient demographics, tumour characteristics, peri-operative and post-operative outcomes of all partial nephrectomies undertaken by a single surgeon between 2014 and 2021 with experience in both laparoscopic and robotic surgery. The Da Vinci surgical system was utilized. Statistical analysis was carried out using GraphPad prism software version 7.03, San Diego, CA, USA. Results: Warm ischemia time was reduced by 2.6 min, length of stay reduced by 1.3 days and acute renal function deterioration was reduced by 55% with all these results being significant with robotic assisted partial nephrectomy compared to laparoscopic partial nephrectomy. Conclusion: This study highlights the benefits of robotic assisted in comparison to laparoscopic partial nephrectomy. Further large-scale prospective studies and cost-benefit analysis of robotic assisted partial nephrectomy would be valuable in confirming these findings and justifying the usage against their financial cost.

Robotic Partial Nephrectomy Is Associated with a Significantly Decreased Rate of Postoperative Pseudoaneurysm Compared to Open and Laparoscopic Partial Nephrectomy

“…In contrast, the robotic approach has several advantages, including three-dimensional visualization, improved visual magni cation, and mechanical dexterity that translate to better surgical outcomes. The ndings of several retrospective analyses that compared the surgical and functional outcomes of RAPN with those of LPN favored robotic surgery by its affording shorter ward ischemia time 2,3,4 , better postoperative renal function 2,3,4 , shorter operative time 3 , and shorter hospital length of stay 4 . Our earlier results support these differences 17 .…”

“…The surgical approach for clinical T1 renal masses has shifted from radical nephrectomy to partial nephrectomy (PN) for preservation of renal function [1][2][3][4] . The original PN was an open approach that was oncologically and surgically effective and safe compared to radical nephrectomy [1][2][3] , yielding a signi cantly decreased rate of renal insu ciency 1,[2][3][4][5] .…”

“…The surgical approach for clinical T1 renal masses has shifted from radical nephrectomy to partial nephrectomy (PN) for preservation of renal function [1][2][3][4] . The original PN was an open approach that was oncologically and surgically effective and safe compared to radical nephrectomy [1][2][3] , yielding a signi cantly decreased rate of renal insu ciency 1,[2][3][4][5] . The introduction of minimally invasive PN (MIPN), laparoscopic and robotic-assisted PN (RAPN) caused a major shift toward minimal invasiveness aimed at decreasing postoperative complication rates, allowing short hospital stay, and lessening recovery time [1][2][3][4][5][6] .…”

“…The original PN was an open approach that was oncologically and surgically effective and safe compared to radical nephrectomy [1][2][3] , yielding a signi cantly decreased rate of renal insu ciency 1,[2][3][4][5] . The introduction of minimally invasive PN (MIPN), laparoscopic and robotic-assisted PN (RAPN) caused a major shift toward minimal invasiveness aimed at decreasing postoperative complication rates, allowing short hospital stay, and lessening recovery time [1][2][3][4][5][6] . RAPN which has now become the most prevalent surgical approach for renal masses treated by partial nephrectomy.…”

Clinical application of superselective transarterial embolization of renal tumors in zero ischaemia robotic-assisted laparoscopic partial nephrectomy

“…Third, the complication rate of renal vessel injury is reduced ( 16 ). In addition, this current research is based on the assistance of the Da Vinci robot SI, which represents a developing and innovative area in many surgical specialties, including urology ( 17 ). It could offer a better field of operation (3D magnified vision) to the surgeon and provide a more precise and smart operation to reduce the amount of intraoperative blood loss and less tissue contact to improve infection risk and protect renal function after surgery than traditional LPN ( 18 ).…”