Robot-Assisted Partial Nephrectomy: A Comparison of the Transperitoneal and Retroperitoneal Approaches

Abstract Purpose: To present the oncologic and functional outcomes of robot-assisted partial nephrectomy (RAPN) and analyze retroperitoneal and transperitoneal approaches. Patients and Methods: RAPN was performed on 103 patients; 44 patients underwent a retroperitoneal and 59 a transperitoneal approach. Demographic, operative, and postoperative data was collected and retrospectively analyzed on all patients. Results: Overall average warm ischemic time was 20.4 (0–48) minutes, total operative time was 175.3 (85–330) minutes, and estimated blood loss was 258.1 (20–3100) mL. When retroperitoneal and transperitoneal approaches were compared, there was no significant difference in warm ischemic time but a significant reduction in both estimated blood loss and total operative time in the retroperitoneal group. Conclusion: Our series would suggest that if performed by a surgeon familiar with a laparoscopic retroperitoneal approach to renal surgery, retroperitoneal RAPN is at least equivalent to the more common t...