Complications of Robotic Oncologic Renal Surgery

Abstract

Radical (RN) or partial nephrectomy (PN) are standard treatment for renal masses, with partial nephrectomy pursued whenever feasible for small renal masses. Most recently, robotic partial nephrectomy (RPN) and robotic radical nephrectomy (RRN) have gained favor as they offer oncologic outcomes similar to their open surgical counter-part, but with benefits of less blood loss, quick recovery, less complications and similar functional outcomes (Nazemi et al., Int Braz J Urol 32:15–22, 2006; Park et al., Korean J Urol 53:519–23, 2012; Sterrett et al., World J Urol 25:193–8, 2007). In fact, RPN is the most common PN approach since 2012 and, currently, it is estimated that about 60% of PN in the USA are performed robotically. Nowadays, in centers with adequate expertise, indications for RPN are the same as for OPN; furthermore, contraindications for RPN are more surgeon- and patient-related, rather than tumor-related. As such, given adequate robotic expertise, in 2017, if a patient is deemed to be a candidate for OPN, he/she is also typically a candidate for RPN, thus delivering the considerable benefits of minimally invasive surgery. The number of RRN has also consistently increased and most recently, reports have shown safety and feasibility for RRN and robotic inferior vena cava (IVC) thrombectomy (RIVCT), as such, expanding the indications of the robotic approach (Abaza et al., Eur Urol Focus 2:601–7, 2017).