title: [Robot-assisted laparoscopic partial nephrectomy: functional and oncological outcomes].
abstract: BACKGROUND
  In recent years, small renal masses (SRM) have been increasingly detected as an incidental finding of radiological or ultrasound studies for other indications. Organ-sparing renal tumor resection as open partial nephrectomy (OPN) is the international standard for renal tumors <7 cm.
  
  
  RESULTS
  Due to technical developments, minimally invasive procedures have emerged as an alternative to OPN. In experienced hands, conventional laparoscopic partial nephrectomy (LPN) has achieved good functional and oncological results comparable to OPN. Robot-assisted laparoscopic partial nephrectomy (RAPN) has been performed since 2004. Compared to LPN, RAPN provides a faster learning curve, better visualization and more versatile instrumentation due to the degrees of freedom of the articulated instruments. After about 30 procedures, a level of experience is reached, which is characterized by good functional results, less blood loss, and shorter warm ischemia time of the kidney as compared to LPN. This can relate to a shorter hospital stay and faster recovery. Complications according to the Clavien classification are mostly grade I and II and are mainly treated conservatively.
  
  
  CONCLUSIONS
  Oncological long-term results are not available yet; so that RAPN cannot be considered as an equivalent treatment to LPN and OPN. Until long-term evidence is available, decisions regarding the surgical technique for organ-sparing renal tumor resection will be determined by patient's wishes and surgeon's preference.
authors.affiliation: Klinik und Poliklinik für Urologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55101, Mainz, Deutschland, frederik.roos@unimedizin-mainz.de.
authors.forename: F C
authors.initials: FC
authors.lastname: Roos
authors.forename: C
authors.initials: C
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Neisius
authors.forename: S
authors.initials: S
authors.lastname: Nestler
authors.forename: J W
authors.initials: JW
authors.lastname: Thüroff
authors.forename: C
authors.initials: C
authors.lastname: Hampel
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009392:Nephrectomy; D059351:Organ Sparing Treatments / Q000379:methods*; D020127:Recovery of Function; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome