A Single Surgeon’s Experience with Open, Laparoscopic, and Robotic Partial Nephrectomy

Objective . To report the perioperative outcomes of patients treated with partial nephrectomy by a single surgeon using three surgical modalities—open, laparoscopic, and robotic. Methods . Between August 2006 and February 2012, 106 consecutive patients underwent open partial nephrectomy (OPN) ( n = 23), laparoscopic partial nephrectomy (LPN) ( n = 48), and robotic partial nephrectomy (RPN) ( n = 35) by a single surgeon. Clinical variables, operative parameters, and renal functional outcomes were analyzed. Results . Preoperative patient characteristics were similar except for baseline glomerular filtration rate (GFR), which was highest in the RPN group ( P = 0.004). Surgery time was longest in the RPN group (244 minutes) and shortest in the OPN group (163 minutes, P < 0.0001). Patients who had OPN had the highest incidence of 30-day complications (30%), while the RPN approach had the lowest (14%, P = 0.008). Conclusions . When performed by a single surgeon, robotic partial nephrectomy appears to be associated with fewer complications than both open and laparoscopic partial nephrectomy. Kidney function was not affected by surgical approach.