Robotic Partial Nephrectomy

The robotic approach to renal surgery, particularly partial nephrectomy, has some inherent challenges, and some familiarity with the da Vinci robotic system is necessary. The surgeon must gain an understanding of the robotic arm movements and range of motion, especially in relation to the clutch and camera. The advent of robotically assisted prostatectomy in 2001 [23] paved the way for widespread accessibility to the da Vinci robotic unit and its application to renal surgery. Since that time, at least one multi-institutional survey has demonstrated superiority of the robotic approach when compared to laparoscopic for outcomes of blood loss, hospital stay and a substantially shorter warm ischemia time, while maintaining equivalence in positive margin rate, operative time and complications. [11] A transperitoneal approach is most commonly used. Prior abdominal operation is not necessarily a contraindication to this procedure, but access should be approached with regard for previous operation(s) by an experienced team.