Initial experience with robot-assisted retroperitoneal partial nephrectomy for suspected renal cell carcinoma.

Emtage, Justin B; Buethe, David D; Russell, Christopher M; Sexton, Wade J

Nephron-sparing surgery is the accepted standard of care for the small renal mass, and minimally invasive techniques have increasingly gained recognition. Robotic-assisted transperitoneal partial nephrectomy (RATPN) has been well described but there are few reports assessing the retroperitoneal approach. Therefore, we present our initial experience with robotic-assisted retroperitoneal partial nephrectomy (RARPN). We identified 14 patients from a single-surgeon IRB-approved database who underwent RARPN for suspected renal cell carcinoma. Our results showed a mean pathologic tumor size of 2.6 cm (SD = 0.9) and a median R.E.N.A.L. nephrometry score of 8. Mean estimated blood loss was 178 cc (SD = 182) and mean warm ischemia time was 28.9 min (SD = 8.9). There were no intra-operative or post-operative complications and mean length of stay was 2.9 days (SD = 1.6). At an average of 4-month follow-up, the mean decrease in renal function was 7.3 %. RARPN is an effective alternative to RATPN and can be safely and successfully applied to selected patients with tumors amenable to nephron preservation.