Robot-Assisted Partial Nephrectomy: A Comparison of the Transperitoneal and Retroperitoneal Approaches

Purpose: To present the oncologic and functional outcomes of robot-assisted partial nephrectomy (RAPN) and analyze retroperitoneal and transperitoneal approaches. Patients and Methods: RAPN was performed on 103 patients; 44 patients underwent a retroperitoneal and 59 a transperitoneal approach. Demographic, operative, and postoperative data was collected and retrospectively analyzed on all patients. Results: Overall average warm ischemic time was 20.4 (0-48) minutes, total operative time was 175.3 (85-330) minutes, and estimated blood loss was 258.1 (20-3100) mL. When retroperitoneal and transperitoneal approaches were compared, there was no significant difference in warm ischemic time but a significant reduction in both estimated blood loss and total operative time in the retroperitoneal group. Conclusion: Our series would suggest that if performed by a surgeon familiar with a laparoscopic retroperitoneal approach to renal surgery, retroperitoneal RAPN is at least equivalent to the more common transperitoneal approach in the outcomes assessed.