Robot-Assisted Partial Nephrectomy with a New Robotic Surgical System: Feasibility and Perioperative Outcomes.

Abstract

Purpose: The aim of this study was to evaluate the feasibility and safety of a novel robotic system (KD-SR-01) for partial nephrectomy. Methods: Seventeen patients with small renal masses (SRMs) (≤4 cm) underwent KD-SR-01 robotic partial nephrectomy (KD-RPN) from December 2020 to March 2021 in our institution. The operative outcomes and perioperative data, including clinical and histological data, were prospectively collected and analyzed. Results: In total, 10 men and 7 women, with a median age of 51 years, underwent KD-RPN. Four transperitoneal procedures and 13 retroperitoneal procedures were performed without conversion to open or conventional laparoscopic surgery. The docking time and robotic operative time were 3.3 and 68.6 minutes, respectively. The warm ischemia time was 16.9 minutes. No major intraoperative or postoperative complications (Clavien grade ≥III) occurred. The duration of postoperative hospital stay was 5 days. Pathologic examination revealed nine clear cell carcinoma, two papillary cell carcinoma, one oncocytoma, and five angiomyolipoma cases. All surgical margins were negative. The estimated glomerular filtration rate (eGFR) on the first postoperative day was significantly decreased compared with the preoperative eGFR (91.7 ± 12.9 mL/min vs 97.9 ± 10.7 mL/min, p = 0.036). However, no significant difference was observed between the preoperative eGFR and the value on the fourth postoperative day (95.7 ± 13.4 mL/min vs 97.9 ± 10.7 mL/min, p = 0.427). Conclusions: KD-RPN was safe and feasible for treatment of SRM. The early oncologic and functional outcomes were promising. Long-term follow-up and well-designed prospective comparative studies with the da Vinci® platform are needed to corroborate these findings.