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Updated: Aug 15, 2025
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
The State of Robotic Partial Nephrectomy: Operative, Functional, and Oncological Outcomes From A Robust
Shirin Razdan1, Kennedy E Okhawere1, Burak Ucpinar1
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
Objective:
To describe the most recent surgical, functional, and oncological outcomes of RPN utilizing one of the largest, prospectively maintained, multi-institution consortium of patients undergoing robotic renal surgery.
Materials And Methods:
Data was obtained from a prospectively maintained multi-institutional database of patients who underwent RPN for clinically localized kidney cancer between 2018 and 2022 by 9 high-volume surgeons. Demographic and tumor characteristics as well as operative, functional, and oncological outcomes were queried.
Results:
A total of 2836 patients underwent RPN. Intraoperative, postoperative, and 30-day major complication rates were 2.68%, 11.39%, and 3.24%, respectively. Median tumor size was 3.0 cm. Tumors with low complexity had a shorter median operative time, lower median EBL, shorter median ischemia time, lower postoperative complication rate, and lower decline in renal function There was no significant difference between tumor complexities with respect to the rate of conversion to radical nephrectomy, conversion to open, major complications, and positive margins. Lower BMI, smaller clinical tumor size, lower tumor complexity, and higher baseline eGFR were significantly associated with trifecta achievement.
Conclusion:
Patient BMI, baseline eGFR, and tumor characteristics such as size and complexity are the most important predictors of trifecta achievement. Patients with complex tumors should be counseled that they are at increased risk of complications and worsening renal function after robotic partial nephrectomy.
Insights
Robotic partial nephrectomy (RPN) outcomes were analyzed in 2836 patients. Lower BMI, smaller tumor size, and lower complexity predict trifecta achievement in robotic kidney cancer surgery.
Area of Science:
- Urology
- Robotic Surgery
- Oncology
Background:
- Robotic partial nephrectomy (RPN) is a key procedure for kidney cancer.
- Assessing RPN outcomes is crucial for surgical planning and patient counseling.
Purpose of the Study:
- To evaluate surgical, functional, and oncological outcomes of RPN.
- To identify predictors of trifecta achievement in robotic renal surgery.
Main Methods:
- Analysis of a prospectively maintained multi-institutional database of 2836 patients undergoing RPN for localized kidney cancer (2018-2022).
- Inclusion of data from 9 high-volume surgeons, examining demographic, tumor, operative, functional, and oncological outcomes.
Main Results:
- RPN demonstrated low intraoperative (2.68%) and 30-day major complication rates (3.24%).
- Lower tumor complexity correlated with shorter operative time, less blood loss, reduced ischemia, fewer complications, and better renal function preservation.
- Lower BMI, smaller tumor size, lower complexity, and higher baseline eGFR were significant predictors of trifecta achievement.
Conclusions:
- Patient BMI, baseline eGFR, and tumor characteristics (size, complexity) are key predictors of trifecta achievement.
- Patients with complex tumors face higher risks of complications and renal function decline post-RPN.
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