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Abstract

In the last 5 years, robot-assisted partial nephrectomy (RAPN) has progressively increased its utilization worldwide for the treatment of renal tumors for 2 reasons: increased number of Da Vinci installed along with incremental experience of Da Vinci users that brought to expand the indications toward larger and more complex cases such as cT1b tumors. 1 Patel H.D. Mullins J.K. Pierorazio P.M. et al. Trends in renal surgery: robotic technology is associated with increased use of partial nephrectomy. J Urol. 2013; 189: 1229-1235 Abstract Full Text Full Text PDF PubMed Scopus (195) Google Scholar , 2 Schiavina R. Mari A. Antonelli A. et al. A snapshot of nephron-sparing surgery in Italy: A prospective, multicenter report on clinical and perioperative outcomes (the RECORd 1 project). Eur J Surg Oncol. 2015; 41: 346-352 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Besides the undebatable benefits of the minimally invasive approach, RAPN allows an optimal dissection of tissues and kidney reconstruction thanks to the magnified three-dimensional vision and to the EndoWrist technology (Intuitive Surgical, Sunnyvale, CA), that led to a short learning curve and excellent perioperative surgical outcomes. 3 Serni S. Vittori G. Masieri L. et al. Robotic vs open simple enucleation for the treatment of T1a-T1b renal cell carcinoma: a single center matched-pair comparison. Urology. 2014; 83 (Epub 2013 Nov 22): 331-337https://doi.org/10.1016/j.urology.2013.08.080 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar However, to date no consensus has been reached on the best approach for the treatment of renal masses. Indeed, open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), and RAPN can be used interchangeably, according to the surgeons' experience, for the treatment of cT1 renal tumors, meaning that evidence in favor of one or the other techniques is lacking and strongly needed to shed light on this controversial issue.