Robotic Partial Nephrectomy: Transperitoneal Technique

Partial nephrectomy has been the standard of care for small renal masses and is endorsed by the American Urological Association for patients with cT1a and select patients with cT1b lesions. Traditionally, this procedure was done through an open incision. With the advent of improved laparoscopic technology, laparoscopic partial nephrectomy remained a difficult and challenging procedure. Over the last decade, however, we have seen an increase in the performance of robotic-assisted laparoscopic partial nephrectomy due to the improved ergonomics and range of movement, wristed instrumentation, super three-dimensional, high-definition visualization provided by the da Vinci® Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA), and quick adaptation by open surgeons. While there are many techniques that have been described, we herein discuss our technique for robotic transperitoneal partial nephrectomy.