Skip to main content
SpringerLink
Log in

Outcomes of Robotic Radical and Partial Nephrectomy

  • Chapter
  • First Online:
Robotic Urologic Surgery

  • 945 Accesses

Abstract

Since the advent of the first laparoscopic nephrectomy in 1990 by Clayman et al., the use of the robotic platform has revolutionized the performance of minimally invasive renal surgery. Over the last decade, the robotic platform as allowed partial nephrectomy to become more feasible due to improved visualization and hilar dissection, as well as expedient tumor excision and renorrhaphy. More recently the retroperitoneal approach has also become a popular option, with surgeons relying on the retroperitoneal approach for posterior and lateral tumors as well as in those patients with hostile abdomens. A systematic review from 2020 comparing robotic radical nephrectomy with laparoscopic and open nephrectomy found longer operative time, shorter length of stay, fewer overall complications, lower estimated blood loss (EBL), and higher total hospital costs. The data on robotic partial nephrectomy shows that the robotic approach results in mixed outcomes for warm ischemia time (WIT), although it is associated with shorter hospital length of stay and shorter operative times when compared to laparoscopic and shorter hospital stay with longer operative times compared to open approach. The retroperitoneal approach appears to be a technically feasible procedure for surgeons who are already familiar with the robotic transperitoneal approach. It may result in faster operative times with shorter length of stay compared to transperitoneal partial nephrectomy without attendant increase in complication rate or positive surgical margin rate.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146:278.

    CAS  PubMed  Google Scholar 

  2. Gaur DD, Agarwal DK, Purohit KC. Retroperitoneal laparoscopic nephrectomy: initial case report. J Urol. 1993;149:103.

    CAS  PubMed  Google Scholar 

  3. Gill IS, Sung GT, Hsu TH, et al. Robotic remote laparoscopic nephrectomy and adrenalectomy: the initial experience. J Urol. 2000;164:2082.

    CAS  PubMed  Google Scholar 

  4. Guillonneau B, Jayet C, Tewari A, et al. Robot assisted laparoscopic nephrectomy. J Urol. 2001;166:200.

    CAS  PubMed  Google Scholar 

  5. Klingler DW, Hemstreet GP, Balaji KC. Feasibility of robotic radical nephrectomy: initial results of single-institution pilot study. Urology. 2005;65:1086.

    PubMed  Google Scholar 

  6. Nazemi T, Galich A, Sterrett S, et al. Radical nephrectomy performed by open, laparoscopy with or without hand-assistance or robotic methods by the same surgeon produces comparable perioperative results. Int Braz J Urol. 2006;32:15.

    PubMed  Google Scholar 

  7. Rogers C, Laungani R, Krane LS, et al. Robotic nephrectomy for the treatment of benign and malignant disease. BJU Int. 2008;102:1660.

    PubMed  Google Scholar 

  8. Anele UA, Marchioni M, Yang B, et al. Robotic versus laparoscopic radical nephrectomy: a large multi-institutional analysis (ROSULA Collaborative Group). World J Urol. 2019;37:2439.

    PubMed  Google Scholar 

  9. Helmers MR, Ball MW, Gorin MA, et al. Robotic versus laparoscopic radical nephrectomy: comparative analysis and cost considerations. Can J Urol. 2016;23:8435.

    PubMed  Google Scholar 

  10. Golombos DM, Chughtai B, Trinh QD, et al. Adoption of technology and its impact on nephrectomy outcomes, a U.S. population-based analysis (2008–2012). J Endourol. 2017;31:91.

    PubMed  Google Scholar 

  11. Hemal AK, Kumar A. A prospective comparison of laparoscopic and robotic radical nephrectomy for T1-2N0M0 renal cell carcinoma. World J Urol. 2009;27:89.

    PubMed  Google Scholar 

  12. Crocerossa F, Carbonara U, Cantiello F, et al. Robot-assisted radical nephrectomy: a systematic review and meta-analysis of comparative studies. Eur Urol. 2020;80(4):428–39.

    PubMed  Google Scholar 

  13. Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol. 2000;163:442.

    CAS  PubMed  Google Scholar 

  14. Becker F, Siemer S, Humke U, et al. Elective nephron sparing surgery should become standard treatment for small unilateral renal cell carcinoma: long-term survival data of 216 patients. Eur Urol. 2006;49:308.

    CAS  PubMed  Google Scholar 

  15. Dash A, Vickers AJ, Schachter LR, et al. Comparison of outcomes in elective partial vs radical nephrectomy for clear cell renal cell carcinoma of 4-7 cm. BJU Int. 2006;97:939.

    PubMed  Google Scholar 

  16. Margulis V, Tamboli P, Jacobsohn KM, et al. Oncological efficacy and safety of nephron-sparing surgery for selected patients with locally advanced renal cell carcinoma. BJU Int. 2007;100:1235.

    PubMed  Google Scholar 

  17. Gill IS, Kavoussi LR, Lane BR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178:41.

    PubMed  Google Scholar 

  18. Gettman MT, Blute ML, Chow GK, et al. Robotic-assisted laparoscopic partial nephrectomy: technique and initial clinical experience with DaVinci robotic system. Urology. 2004;64:914.

    PubMed  Google Scholar 

  19. Michli EE, Parra RO. Robotic-assisted laparoscopic partial nephrectomy: initial clinical experience. Urology. 2009;73:302.

    PubMed  Google Scholar 

  20. Benway BM, Bhayani SB, Rogers CG, et al. Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes. J Urol. 2009;182:866.

    PubMed  Google Scholar 

  21. DeLong JM, Shapiro O, Moinzadeh A. Comparison of laparoscopic versus robotic assisted partial nephrectomy: one surgeon’s initial experience. Can J Urol. 2010;17:5207.

    PubMed  Google Scholar 

  22. Ellison JS, Montgomery JS, Wolf JS Jr, et al. A matched comparison of perioperative outcomes of a single laparoscopic surgeon versus a multisurgeon robot-assisted cohort for partial nephrectomy. J Urol. 2012;188:45.

    PubMed  Google Scholar 

  23. Zhang X, Shen Z, Zhong S, et al. Comparison of peri-operative outcomes of robot-assisted vs laparoscopic partial nephrectomy: a meta-analysis. BJU Int. 2013;112:1133.

    PubMed  Google Scholar 

  24. Khalifeh A, Autorino R, Hillyer SP, et al. Comparative outcomes and assessment of trifecta in 500 robotic and laparoscopic partial nephrectomy cases: a single surgeon experience. J Urol. 2013;189:1236.

    PubMed  Google Scholar 

  25. Wu Z, Li M, Song S, et al. Propensity-score matched analysis comparing robot-assisted with laparoscopic partial nephrectomy. BJU Int. 2015;115:437.

    PubMed  Google Scholar 

  26. Masson-Lecomte A, Bensalah K, Seringe E, et al. A prospective comparison of surgical and pathological outcomes obtained after robot-assisted or pure laparoscopic partial nephrectomy in moderate to complex renal tumours: results from a French Multicentre Collaborative Study. BJU Int. 2013;111:256.

    PubMed  Google Scholar 

  27. Masson-Lecomte A, Yates DR, Hupertan V, et al. A prospective comparison of the pathologic and surgical outcomes obtained after elective treatment of renal cell carcinoma by open or robot-assisted partial nephrectomy. Urol Oncol. 2013;31:924.

    PubMed  Google Scholar 

  28. Masson-Lecomte A, Yates DR, Bensalah K, et al. Robot-assisted laparoscopic nephron sparing surgery for tumors over 4 cm: operative results and preliminary oncologic outcomes from a Multicentre French Study. Eur J Surg Oncol. 2013;39:799.

    CAS  PubMed  Google Scholar 

  29. Shen Z, Xie L, Xie W, et al. The comparison of perioperative outcomes of robot-assisted and open partial nephrectomy: a systematic review and meta-analysis. World J Surg Oncol. 2016;14:220.

    PubMed  PubMed Central  Google Scholar 

  30. Grivas N, Kalampokis N, Larcher A, et al. Robot-assisted versus open partial nephrectomy: comparison of outcomes. A systematic review. Minerva Urol Nefrol. 2019;71:113.

    PubMed  Google Scholar 

  31. Xia L, Wang X, Xu T, et al. Systematic review and meta-analysis of comparative studies reporting perioperative outcomes of robot-assisted partial nephrectomy versus open partial nephrectomy. J Endourol. 2017;31:893.

    PubMed  Google Scholar 

  32. Tsai SH, Tseng PT, Sherer BA, et al. Open versus robotic partial nephrectomy: systematic review and meta-analysis of contemporary studies. Int J Med Robot. 2019;15:e1963.

    PubMed  Google Scholar 

  33. Aboumarzouk OM, Stein RJ, Eyraud R, et al. Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol. 2012;62:1023.

    PubMed  Google Scholar 

  34. McDougall EM, Clayman RV. Laparoscopic nephrectomy for benign disease: comparison of the transperitoneal and retroperitoneal approaches. J Endourol. 1996;10:45.

    CAS  PubMed  Google Scholar 

  35. Choo SH, Lee SY, Sung HH, et al. Transperitoneal versus retroperitoneal robotic partial nephrectomy: matched-pair comparisons by nephrometry scores. World J Urol. 2014;32:1523.

    PubMed  Google Scholar 

  36. Hughes-Hallett A, Patki P, Patel N, et al. Robot-assisted partial nephrectomy: a comparison of the transperitoneal and retroperitoneal approaches. J Endourol. 2013;27:869.

    PubMed  Google Scholar 

  37. Maurice MJ, Kaouk JH, Ramirez D, et al. Robotic partial nephrectomy for posterior tumors through a retroperitoneal approach offers decreased length of stay compared with the transperitoneal approach: a propensity-matched analysis. J Endourol. 2017;31:158.

    PubMed  Google Scholar 

  38. Arora S, Heulitt G, Menon M, et al. Retroperitoneal vs transperitoneal robot-assisted partial nephrectomy: comparison in a multi-institutional setting. Urology. 2018;120:131.

    PubMed  Google Scholar 

  39. Abaza R, Gerhard RS, Martinez O. Feasibility of adopting retroperitoneal robotic partial nephrectomy after extensive transperitoneal experience. World J Urol. 2020;38:1087.

    CAS  PubMed  Google Scholar 

  40. Stroup SP, Hamilton ZA, Marshall MT, et al. Comparison of retroperitoneal and transperitoneal robotic partial nephrectomy for Pentafecta perioperative and renal functional outcomes. World J Urol. 2017;35:1721.

    PubMed  Google Scholar 

  41. Choi CI, Kang M, Sung HH, et al. Comparison by Pentafecta criteria of transperitoneal and retroperitoneal robotic partial nephrectomy for large renal tumors. J Endourol. 2020;34:175.

    PubMed  Google Scholar 

  42. Xia L, Zhang X, Wang X, et al. Transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: a systematic review and meta-analysis. Int J Surg. 2016;30:109.

    PubMed  Google Scholar 

  43. Pavan N, Derweesh I, Hampton LJ, et al. Retroperitoneal robotic partial nephrectomy: systematic review and cumulative analysis of comparative outcomes. J Endourol. 2018;32:591.

    PubMed  Google Scholar 

  44. McLean A, Mukherjee A, Phukan C, et al. Trans-peritoneal vs. retroperitoneal robotic assisted partial nephrectomy in posterior renal tumours: need for a risk-stratified patient individualised approach. A systematic review and meta-analysis. J Robot Surg. 2020;14:1.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA

    Shirin Razdan & Ketan K. Badani

Authors
  1. Shirin Razdan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ketan K. Badani
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA

    Peter Wiklund

  2. Department of Urology, ORSI Academy, Aalst, Belgium

    Alexandre Mottrie

  3. Pediatric Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

    Mohan S Gundeti

  4. Urology, Global Robotics Institute, Celebration, FL, USA

    Vipul Patel

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Razdan, S., Badani, K.K. (2022). Outcomes of Robotic Radical and Partial Nephrectomy. In: Wiklund, P., Mottrie, A., Gundeti, M.S., Patel, V. (eds) Robotic Urologic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-00363-9_53

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-00363-9_53

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-00362-2

  • Online ISBN: 978-3-031-00363-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation