title: Robotic partial nephrectomy: The new horizon.
abstract: BACKGROUND
  There has been an exponential growth in the reporting of series of robotic partial nephrectomy (RPN). We review the technique of RPN and the outcomes from large single-centre series of RPN.
  
  
  METHODS
  We searched databases to identify original articles related to RPN. For the technical aspects, we describe our technique and provide a general review of previous work. For outcomes, we reviewed previous reports using more rigid criteria, including only single-institution studies with at least 50 patients undergoing RPN.
  
  
  RESULTS
  We found seven retrospective studies that met our criteria, with a total of 701 patients. Mean tumour size was 2.8 cm, with an average R.E.N.A.L. score (Radius, tumour size as maximum diameter; Exophytic/endophytic properties of the tumour, Nearness of tumour deepest portion to the collecting system or sinus, Anterior, a/posterior, p, descriptor, and the Location relative to the polar line) of 6.8. The mean warm ischaemia time was 21 min and mean operative duration was 196 min. The mean estimated blood loss was 182 mL, with a 7.4% transfusion rate. The conversion rate was 1.7% and the postoperative complication rate was 14%. The mean length of stay was 3.6 days. There were positive surgical margins in 1.7% of patients. The mean decrease in renal function was 5.4% and the mean follow-up was 8.4 months.
  
  
  CONCLUSIONS
  RPN is feasible and safe for different levels of complexity of renal tumours. Perioperative outcomes are comparable to those found with more established techniques. Future studies should compare different approaches and prioritise prospective and randomised designs.
authors.affiliation: Center for Laparoscopic and Robotic Surgery - Urology, Cleveland Clinic Foundation, Cleveland, OH, United States.
authors.forename: Humberto
authors.initials: H
authors.lastname: Laydner
authors.affiliation: Center for Laparoscopic and Robotic Surgery - Urology, Cleveland Clinic Foundation, Cleveland, OH, United States.
authors.forename: Jihad H
authors.initials: JH
authors.lastname: Kaouk
keywords: BMI, body mass index; EBL, estimated blood loss; Kidney neoplasms; LOS, length of stay; Laparoscopic; NSS, nephron-sparing surgery; Nephron-sparing; Partial nephrectomy; RN, radical nephrectomy; RPN, (robotic) partial nephrectomy; Robotics; WIT, warm ischaemia time; eGFR, estimated GFR