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MINIMALLY INVASIVE LAPAROSCOPIC AND ROBOT ASSISTED PARTIAL NEPHRECTOMY: A BRIEF HISTORY AND REVIEW


Authors: E. S. Wisenbaugh;  S. M. Cheney;  G. L. Martin;  B. Rocco;  E. P. Castle
Authors‘ workplace: Mayo Clinic Arizona
Published in: Urol List 2011; 9(4): 17-21

Overview

Robot assisted partial nephrectomy (RAPN) has recently emerged as an alternative approach to pure laparoscopy for minimally invasive nephron sparing surgery for small renal tumors, and it’s benefits are still being evaluated. We summarize the evolution of treatment of these small tumors, and review the literature of direct comparisons between the laparoscopic and the robot assisted approach. Results from the largest studies to date suggest there may be a benefit in reducing warm ischemia time with the robot. Benefits in the other parameters measured such as operative time, estimated blood loss, complication rates and pos­itive surgical margins were less clear, but seem to be at least comparable between the two approaches. We conclude that while the benefits to using the robotic approach need to be further investigated, outcomes so far appear to be at least equivalent to pure laparoscopy. Other important benefits include facilitation of dissection in more complex renal masses, and creating wider access to nephron-sparing surgery in the community.

Key words:
robot assisted partial nephrectomy, laparoscopic partial nephrectomy, T1 renal tumors, nephron sparing surgery


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