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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.

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