Three-Dimensional Virtual Models in Robot Assisted Partial Nephrectomy: A Needed Tool in the Era of Precision Surgery

Robot-assisted partial nephrectomy (RAPN) has become the gold standard for treating localized renal cell carcinoma (RCC) in high-volume centres. However, increasing tumor complexity demands refined preoperative planning tools. This review summarizes current evidence regarding the use of three-dimensional virtual models (3DVM) in RAPN, focusing on their clinical applications, outcomes and future perspectives.

3DVMs are generated from contrast-enhanced CT scans through segmentation and reconstruction, enabling interactive anatomical visualization. These models provide functional tools such as perfusion territory mapping, volumetric renal function prediction and nephrometry-based complexity stratification. Integration with augmented reality (AR) platforms allows real-time intraoperative navigation. Comparative studies and meta-analyses demonstrate that 3DVM-guided RAPN is associated with reduced warm ischemia time (WIT), lower estimated blood loss (EBL), higher trifecta/pentafecta achievement and improved postoperative renal function, particularly in complex tumors. Additionally, 3DVM enhance surgical education and patient counselling. 3DVM represent a pivotal advancement in personalized urologic surgery. By improving anatomical comprehension, surgical precision, and planning of selective ischemia strategies, they contribute to superior intraoperative and functional outcomes in RAPN. Although promising, broader implementation requires standardization, cost-effectiveness validation and further multicentre prospective studies.