Combined Laparoscopic-Robotic Partial Nephrectomy: A Comparative Analysis of Technical Efficiency and Safety

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Partial nephrectomy is the standard for clinical stage 1 renal tumors.
• Integrating laparoscopic and robotic techniques offers potential advantages in surgical precision and efficiency.

Purpose of the Study:

• To evaluate the feasibility and safety of a combined partial nephrectomy (CPN) approach.
• To compare perioperative and postoperative outcomes of CPN with traditional laparoscopic (LPN) and robot-assisted partial nephrectomy (RAPN).

Main Methods:

• Retrospective analysis of 99 patients with clinical stage 1 renal tumors.
• Patients underwent LPN (n=31), RAPN (n=16), or CPN (n=52).
• CPN involved laparoscopic mobilization followed by robotic tumor resection and suturing.

Main Results:

• No significant demographic differences between groups.
• CPN demonstrated comparable operative time to LPN and shorter time than RAPN.
• Warm ischemia time and estimated blood loss for CPN were similar to RAPN and better than LPN.
• No major complications (Clavien-Dindo grade ≥3) were observed in any group.

Conclusions:

• Combined partial nephrectomy (CPN) is a feasible and safe surgical approach for clinical stage 1 renal tumors.
• CPN leverages the benefits of both laparoscopic and robotic surgery, offering efficiency and precision.
• CPN achieves comparable oncological and functional results with improved perioperative parameters compared to LPN and RAPN.