Robotic Vessel Sealer vs. Robotic Bipolar Grasper in Partial Nephrectomy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Robotic-assisted partial nephrectomy (RAPN) is a key nephron-sparing surgical technique.
• Vessel sealing technology is critical for RAPN outcomes, impacting blood loss and ischemia time.
• This study evaluates robotic vessel sealers against conventional bipolar energy in RAPN.

Purpose of the Study:

• To compare the efficacy and safety of robotic vessel sealers versus bipolar energy in RAPN.
• To analyze differences in ischemia time, estimated blood loss (EBL), and postoperative complications.
• To assess functional outcomes and identify optimal device selection for RAPN.

Main Methods:

• Retrospective analysis of 112 patients undergoing RAPN between 2023-2025.
• Comparison between robotic vessel sealer (VS) group (n=54) and bipolar energy group (n=58).
• Analysis of perioperative metrics including ischemia time, EBL, operative time, and postoperative complications.

Main Results:

• The VS group demonstrated significantly lower EBL (40 mL vs. 132.5 mL, p=0.037).
• Ischemia time was comparable between groups (24.5 min vs. 20.46 min, p=0.444).
• No significant differences in operative time, console time, docking time, or complications were observed (p > 0.05).

Conclusions:

• Robotic vessel sealers offer reduced blood loss in RAPN compared to bipolar energy.
• Both techniques are suitable for tumors of similar complexity, suggesting minimal selection bias.
• Further research, including RCTs and multicenter studies, is needed to evaluate long-term renal function and cost-effectiveness.