Tubeless Retroperitoneal Robot-assisted Partial Nephrectomy: An Innovative Approach to Treat Early Renal Tumor

Retroperitoneal robot-assisted partial nephrectomy (RRPN) has achieved widespread acceptance worldwide. However, the complications and discomfort associated with tubes cannot be overlooked. Consequently, we have initiated Tubeless RRPN (TLRRPN). This approach eliminates the need for tracheal intubation, central venous catheterization, urinary catheters, or abdominal drainage.

From 2024-07 to 2025-06, a total of 78 patients underwent RRPN at our center. Following a 1:1 propensity scores matching process, we compared 14 patients who underwent TLRRPN with 14 matched patients receiving Traditional RRPN (TRRPN). Anesthetic management and surgical procedures were systematically detailed, and perioperative outcomes were comprehensively assessed.

All 28 patients underwent successful R0 tumor resection, with no conversions or major complications reported in either group. Patients who received TLRRPN resumed oral intake and ambulation significantly earlier (1.03 hours vs. 22.20 hours and 1.03 hours vs. 30.55 hours, p <0.001), experienced a shorter postoperative hospital stay (26.00 hours vs. 91.43 hours, p < 0.001), and incurred lower overall costs. No anesthesia- or surgery-related complications were observed, and postoperative pain was significantly reduced in the TLRRPN group compared to the TRRPN group.

TLRRPN is a safe, efficient, innovative, cost-effective, and selective surgical procedure. This operation fundamentally reduces the adverse effects associated with tubes in patients and significantly facilitates rapid recovery.