Minimally invasive surgical techniques have revolutionized the surgical management of kidneycancer. Current evidence suggests that the surgical developments gained by traditional laparoscopy have beenadvanced by the robotic platform, particularly as it has been applied to techniques for nephron preservation.
The medical literature from peer-reviewed journals was reviewed to evaluate the feasibility and efficacyof robotic-assisted surgery in the management of renal cell carcinoma. Particular attention was paid tostudies comparing robotic-assisted surgery with more traditional surgical techniques. In this review, we havehighlighted the evolution of robotic assistance for renal surgery as it pertains to renal oncology. The differingapproaches to standard surgeries are discussed as well as current trends to improve perioperative outcomes. In addition, we have reviewed the application of robotic assistance to more complex cases and highlight technologicaladvancements that have pushed the boundaries of surgical care.
Robotic-assisted renal surgery is effective for appropriately selected patients. Robotic-assisted radicalnephrectomy provides equivalent outcomes to traditional open and laparoscopic approaches, albeit with addedfinancial burden. Robotic-assisted partial nephrectomy - through either transperitoneal or retroperitonealaccess - can provide superior outcomes to laparoscopic approaches due to several technical advantages,including improved instrument articulation.
Robotic assistance has transformed the delivery of surgical care to the patient with renal cellcarcinoma. For renal surgery, morbidity and patient satisfaction are potentially improved when using roboticplatforms compared with open and traditional laparoscopic approaches without compromising oncologicalcontrol, and this is particularly true for nephron-sparing surgery.
Cancer control : journal of the Moffitt Cancer Center. 2015 Jul [Epub]
Justin B Emtage, Gautum Agarwal, Wade J Sexton
Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.