The Influence of 3D Technology Integration on Laparoscopic Partial Nephrectomy Practice and Surgical Outcomes

Partial nephrectomy (PN) is the standard treatment for renal cell carcinoma (RCC), offering cancer control with renal preservation. Three-dimensional laparoscopy addresses the limitations of traditional two-dimensional systems by enhancing depth perception and accuracy. This study evaluates the impact of 3D laparoscopy on PN for larger and complex tumors. We retrospectively analyzed 200 laparoscopic nephrectomies by a single surgeon between 2020 and 2024, comparing pre-3D and post-3D groups (100 cases each). Key outcomes included the rate of PN, warm ischemia time (WIT), and operative time. The post-3D group demonstrated a significant increase in PN for tumors >4 cm (48% vs. 35%, p = 0.028) and high RENAL scores ≥8 (41% vs. 29%, p = 0.035). Median WIT was significantly shorter (24 min vs. 29 min, p = 0.018 for larger tumors; 26 min vs. 32 min, p = 0.022 for high complexity). Total operative time was also reduced (175 min vs. 195 min, p = 0.031). Positive surgical margins were lower in the post-3D group (0% vs. 2%), and complication rates were comparable (5% vs. 4%, p = 0.712). Three-dimensional laparoscopy significantly improves the feasibility and precision of PN for larger and complex tumors, enhancing outcomes without increasing complications.