Comparative Analysis of Robotic and Laparoscopic Partial Nephrectomy: Insights Into Precision and Efficiency

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Partial nephrectomy is a crucial nephron-sparing technique for preserving renal function.
• Laparoscopic (LPN) and robotic-assisted partial nephrectomy (RPN) represent advancements in minimally invasive approaches.
• These techniques aim to balance technical complexity with oncological outcomes and patient recovery.

Purpose of the Study:

• To compare the perioperative outcomes of laparoscopic partial nephrectomy (LPN) versus robotic-assisted partial nephrectomy (RPN).
• To evaluate key surgical parameters including ischemia time, blood loss, and tumor characteristics.
• To assess the feasibility of transitioning from LPN to RPN within a single-surgeon experience.

Main Methods:

• Retrospective analysis of 205 patients undergoing LPN (143) or RPN (62) between 2008 and 2024.
• Data collected on ischemia time, blood loss, tumor diameter (CT and pathology), and postoperative recovery.
• Statistical analysis using t-tests, ANOVA, and Fisher's exact tests to compare groups.

Main Results:

• No significant differences observed in ischemia time (LPN: 22.3 min vs. RPN: 20.6 min) or blood loss (LPN: 78.97 mL vs. RPN: 90.11 mL).
• Tumor diameters were comparable between LPN and RPN groups based on CT and pathological assessments.
• Bulldog clamp usage significantly reduced bleeding for both vein and artery, but did not impact operating time.

Conclusions:

• Transitioning from LPN to RPN can be safely accomplished with comparable perioperative outcomes in a single-surgeon setting.
• Findings support the feasibility of robotic surgery but do not demonstrate superiority over laparoscopic approaches.
• Further prospective randomized trials are needed to establish definitive patient benefits and cost-effectiveness.