title: Renal cancer from laparoscopic to robotic: How to proceed.
abstract: The benefits laparoscopic surgery brings to the table are well established in the literature. In our environment however, still most of the reconstructive/oncologic  procedures are performed as open surgery. This can be explained by the multiple challenges this technique involves, as well as a demanding learning curve. Technology has  provided means to improve precision and usefulness of laparoscopy, as well as broaden its use amongst the medical community by shortening its learning curve. Renal tumors  have been managed by laparoscopic approach for the past 20 years. During this time, many studies appeared in the literature comparing this procedure with open surgery. In  the vast majority, laparoscopic surgery has the upper hand in regards of perioperative events. A number of series are available regarding the feasibility of robotic radical nephrectomy, however there is no literature available that demonstrates  better outcome of robotic radical nephrectomy compared to standard laparoscopy. Laparoscopic partial nephrectomy is technically difficult, which has prevented its massive  spread through the urologist community, even amongst trained laparoscopists. Current reports are starting to favor robotic partial nephrectomy over standard laparoscopy  regarding perioperative outcomes, with similar oncologic results. More studies have to be performed in order to elucidate the importance of NOTES and LESS in the  treatment on localized renal cancer, but the use of the robot will lower their learning curve and probably make them attractive in the short term. Even though this  technology has brought laparoscopy closer to a greater number of surgeons, physicians should become familiar and proficient in conventional laparoscopic procedures  before embarking into robotics.
authors: Faculty of Medicine, University of Chile.
authors: Andrés
authors: A
authors: Silva-Waissbluth
authors: Ivar
authors: I
authors: Vidal-Mora
authors: Octavio A
authors: OA
authors: Castillo
mesh_terms: D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009392:Nephrectomy; D012371:Robotics; D013520:Urologic Surgical Procedures / Q000379:methods*