Robot-assisted partial nephrectomy: Complex tumors and evolving techniques

Several investigators have demonstrated the feasibility of robot-assisted partial nephrectomy (RAPN) for the management of renal tumors of increasing size and greater anatomical complexity, allowing RAPN to be offered to more patients, including those with larger, endophytic, and central masses. In this chapter, we examine the utility of RAPN for complex and challenging renal masses, highlighting recent innovations in technique and approach as well as emerging techniques that provide a window into the future of RAPN. Studies have demonstrated that RAPN can be performed safely and with acceptable outcomes for increasingly complex renal tumors. As nascent procedure, RAPN continues to evolve in its technique. New frontiers in RAPN aimed at enhancing the surgeon’s ability to provide excellent oncologic control and hemostatic repair of the renal defect continue to be explored. Future technical innovation in robotic instrumentation may also enhance the RAPN technique.