Early experience and operative technique of robotic‐assisted partial nephrectomy

Abstract

We report the largest RAPN study in Australia or New Zealand to date. Initial results suggest that RAPN can be safely introduced into the Australian public and private health systems, and has been effective in oncologic control and renal function preservation.

Comparison of perioperative, renal and oncologic outcomes in robotic‐assisted versus open partial nephrectomy

“…Furthermore, there was no significant difference in operation time between groups ( P = 0.16) despite our RAPN series accommodating the surgeons’ learning curve (i.e. the first 50 cases), suggesting early plateau of the RAPN learning gradient as proposed in earlier reports …”

“…Routine arterial clamping is frequently considered a drawback to RAPN due to associated renal ischaemia . This is in comparison to OPN where renal vessel clamping is not usually required.…”

“…RAPN technique was as previously described . Surgeries were performed transperitoneally, except in posterior hilar tumours where a retroperitoneal approach was used.…”

“…RAPN technique was as previously described. 6 Surgeries were performed transperitoneally, except in posterior hilar tumours where a retroperitoneal approach was used. Renal vein clamping was reserved for central hilar tumours; whilst renal artery occlusion was universal during all other tumour excisions.…”

“…Since the first reported series in 2014, subsequent Australian data on RAPN is lacking. 6 Accompanied by a paucity in worldwide literature comparing OPN to RAPN, 7 this has led to healthcare funding bodies refusing to subsidize costs of robotic surgery for patients in whom RAPN has been recommended, citing a lack of proven benefit over open surgery. In Australia, a resultant financial imbalance has left many patients outof-pocket or seeking alternative treatments.…”