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Updated: Jan 8, 2026

Robot-Assisted Kidney Transplantation

Robot-Assisted Kidney Transplantation

Published on: July 19, 2021

Renal Function Outcomes After Soft-Coagulation Versus Robot-Assisted Partial Nephrectomy.

Ryunosuke Nakagwa¹, Takahiro Nohara¹, Taiki Kamijima¹

¹Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

Asian Journal of Endoscopic Surgery

|December 16, 2025

Summary

Robot-assisted partial nephrectomy better preserves renal function compared to soft-coagulation-assisted open partial nephrectomy. The robotic approach demonstrated superior outcomes in preserving estimated glomerular filtration rate post-surgery.

Keywords:

nephron‐sparing surgery off‐clamp robot‐assisted partial nephrectomy soft coagulation

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Area of Science:

Urology
Nephrology
Surgical Oncology

Background:

Partial nephrectomy is crucial for localized renal tumors, balancing oncological control with renal function preservation.
Minimizing ischemia during partial nephrectomy is a key surgical goal to protect kidney function.

Purpose of the Study:

To compare renal function outcomes between soft-coagulation-assisted open partial nephrectomy (off-clamp) and robot-assisted partial nephrectomy (temporary clamping).

Main Methods:

Retrospective analysis of 229 patients undergoing either soft-coagulation-assisted open partial nephrectomy (n=47) or robot-assisted partial nephrectomy (n=182).
Renal function assessed by percent change in estimated glomerular filtration rate (eGFR) at multiple postoperative time points.
Multivariable linear regression identified predictors of renal function decline.

Main Results:

Soft-coagulation-assisted open partial nephrectomy showed significantly greater eGFR decline at all evaluated time points compared to robot-assisted surgery.
Postoperative day 1 eGFR change: -21.9% (soft-coagulation) vs. -11.9% (robotic) (p=0.0001).
Robot-assisted surgery and younger age were independent predictors of better 12-month renal function preservation.

Conclusions:

Soft-coagulation-assisted open partial nephrectomy led to greater renal function decline despite theoretical advantages in avoiding ischemia.
Robot-assisted partial nephrectomy achieved superior renal function preservation.
Enhanced surgical precision and minimized parenchymal injury likely contribute to the superior outcomes with robotic assistance.