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

Partial nephrectomy represents a nephron-sparing strategy aimed at preserving renal function while balancing increased technical complexity and potential oncological considerations. Innovations in minimally invasive surgery, especially laparoscopic (LPN) and robotic-assisted partial nephrectomy (RPN), have markedly enhanced patient recovery durations and facilitated increased surgical precision. This study compares the outcomes of these approaches across key surgical parameters.

This retrospective analysis included 205 patients who underwent LPN (143) or RPN (62) between 2008 and 2024. The parameters examined encompassed ischemia time, blood loss, tumor diameter (as assessed by CT and pathology), and postoperative recovery. Statistical methods: t-tests, ANOVA, and Fisher's exact tests, were utilized to assess group differences.

No significant differences were found in ischemia time (LPN: 22.3 min vs. RPN: 20.6 min, p = 0.391) or blood loss (LPN: 78.97 mL vs. RPN: 90.11 mL, p = 0.676). Tumor diameters were similar between groups for CT and pathology (p > 0.05). Analysis of bulldog usage revealed that both vein (p = 0.023) and artery (p = 0.046) clamps significantly reduced bleeding. However, bulldog utilization showed no significant impact on operating time (p > 0.05).

This study demonstrates that, within a single-surgeon experience, transition from LPN to RPN can be achieved safely, with comparable perioperative outcomes. These findings support feasibility rather than superiority of robotic surgery, and broader conclusions regarding patient benefit or cost require prospective randomized evaluation.