Robot‐assisted approach improves surgical outcomes in obese patients undergoing partial nephrectomy

Abstract

At a high-volume centre, the robot-assisted approach offers less blood transfusion, shorter operating time, faster recovery, and fewer peri-operative complications compared with the open approach in obese patients undergoing partial nephrectomy for small renal masses. In this setting, RAPN may be a preferable treatment option.

Open versus robotic partial nephrectomy: Systematic review and meta‐analysis of contemporary studies

“…In subgroup analysis, we found that in patients with BMI < 28, RaPN associated with a decreased PSM rate. Malkoc et al reported no significant PSM difference in obese patients who underwent RaPN compared with OPN (4% versus 3.4%, P = 0.82). Others revealed no difference in PSM in obese patients undergoing RaPN compared with nonobese ones (3.5% versus 2.8%, P = 0.383).…”

“…Thirty‐four eligible studies included 60 808 patients who underwent PN, of whom 19 638 underwent RaPN with mean age 58.9 years and 41 170 underwent OPN with mean age 58.5 years. Table presents the baseline patient demographics of all enrolled studies.…”

Surgical and Minimally Invasive Therapies for the Management of the Small Renal Mass

“…RAPN has recently been reported to convey a clear benefit over open surgery, in terms of perioperative outcomes, in obese patients with cT1 tumours, in a retrospective study from a single, high volume US centre [27]. This reflects a more generally perceived benefit of robotic surgery as being especially important as the population prevalence of obesity increases [28].…”

Size is no barrier: robot‐assisted partial nephrectomy in patients with a high body mass index

“…In the February edition of the BJUI , Malroc et al. from the Cleveland Clinic presented their single centre series of partial nephrectomy (PN) in obese patients. Here they examined a large retrospective cohort of obese patients [body mass index (BMI) >30 kg/m 2 ] undergoing PN over a 4‐year period by either open (OPN) or robot‐assisted (RAPN) approaches and compared the peri‐ and postoperative outcomes.…”

“… demonstrating a lower incidence of complications and blood loss, and shorter LOS compared with the OPN technique. In contrast, the current study attempts to evaluate obesity independently of comorbidities to better understand its relationship to intra‐ and postoperative outcomes; and hence identify the ideal approach for the obese patient. However, this limits the applicability of the study as they acknowledge that the generalisability is somewhat compromised, with a significant proportion of obese patients having covert or undiagnosed comorbidities.…”