Robotic retroperitoneal surgery: a contemporary review

Robotic-assisted renal surgery is being increasingly utilized for various kidney diseases; however, the majority of these are performed via a transperitoneal approach. Retroperitoneal robotic surgery is a relatively new technique, which allows direct access to the posterolateral surface of the kidney, as well as posterior hilar structures. In this review, we summarize the most recent publications and review our experience of retroperitoneal robotic surgery.

Retroperitoneal robotic surgery has been successfully applied to radical nephrectomy, partial nephrectomy and pyeloplasty. The current series, although few, find this approach ideal for posterior and lateral renal masses, and technically feasible with the advances in robotic technology. The retroperitoneal approach has been shown to decrease operative times, narcotic need and permit quicker return of bowel function. Furthermore, there does not appear to be any increase in perioperative complications using this approach.

The limited data using this technique offer an encouraging outlook on robotic retroperitoneal surgery. The retroperitoneal approach permits direct access to the renal hilum, no need for bowel mobilization and excellent visualization for posteriorly located renal disease.