Robotic versus Laparoscopic Partial Nephrectomy in the New Era: Systematic Review.

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Advancements in imaging and minimally invasive surgical techniques have refined renal tumor treatment.
• Nephron-sparing surgery is the established standard for T1 renal masses.
• Partial nephrectomy aims to preserve kidney function while removing tumors.

Purpose of the Study:

• To compare the benefits and outcomes of robotic partial nephrectomy versus laparoscopic partial nephrectomy.
• To evaluate the safety and efficacy of robotic-assisted minimally invasive surgery for renal tumors.

Main Methods:

• Systematic review conducted according to PRISMA criteria (September 2022).
• Inclusion of clinical trials, cohort, and case-control studies (2000-2022) on adult T1 renal cancer.
• Comparison of robotic, laparoscopic, and open partial nephrectomy techniques; bias assessment using Newcastle-Ottawa scale.

Main Results:

• Robotic partial nephrectomy demonstrated significantly shorter warm ischemia times.
• Total operative time was longer in robotic surgery groups.
• No significant differences were observed in severe surgical complications (Clavien III-V) between the techniques.

Conclusions:

• Robotic partial nephrectomy is a safe and effective minimally invasive procedure for T1 renal masses.
• It offers advantages including reduced warm ischemia time and a shorter learning curve compared to laparoscopy.
• Robotic surgery provides the benefits of minimally invasive approaches with comparable safety profiles.