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Transperitoneal vs. retroperitoneal robotic partial nephrectomy: a matched-paired analysis.
World journal of urology
  • Harsha R Mittakanti, Swedish Urology Group, Seattle, Washington, USA.
  • Gerald Heulitt, Swedish Urology Group
  • Hsin-Fang Li, Providence St Vincent Medical Center
  • James R Porter, Swedish Medical Center, Seattle, WA, USA
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PURPOSE: When performing robotic nephron-sparing surgery (NSS) for renal tumors, either a transperitoneal approach or retroperitoneal approach can be utilized. The operative technique for robotic retroperitoneal partial nephrectomy (RPPN) is discussed and a matched-paired analysis comparing both RPPN and transperitoneal partial nephrectomy (TPPN) at a single institution is discussed.

MATERIALS AND METHODS: A retrospective review over a 10-year period (2006-2016) was performed for all patients who underwent robotic partial nephrectomy. A total of 281 patients underwent RPPN and 263 patients underwent TPPN. A matched-paired analysis was performed on 166 pairs of patients and the outcomes reviewed.

RESULTS: Operative time (p < 0.001) and estimated blood loss (p < 0.001) were significantly less in the RPPN group compared to the TPPN group. No differences (p > 0.05) were seen with regard to complexity of cases, warm ischemia time, tumor pathology, positive margin rates, complications, or kidney function post-operatively.

CONCLUSIONS: Robotic RPPN and TPPN can both be used for NSS with good results. RPPN, when used appropriately, can lead to shorter operative times, less blood loss and equivalent oncologic and post-operative outcomes. Surgeon comfort and expertise will help determine which approach to use.

Clinical Institute
Kidney & Diabetes
Citation Information
Harsha R Mittakanti, Gerald Heulitt, Hsin-Fang Li and James R Porter. "Transperitoneal vs. retroperitoneal robotic partial nephrectomy: a matched-paired analysis." World journal of urology (2019)
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