Evaluation of robotic and laparoscopic partial nephrectomy for small renal tumours (T1a)


Correspondence: Kamran Ahmed, MRC Centre for Transplantation, King's College London, King's Health Partners, St Thomas Street, London SE1 9RT, UK.

e-mail: k.ahmed@imperial.ac.uk



  • To compare laparoscopic partial nephrectomy (LPN) with robotic PN (RPN) using meta-analytical techniques, since there has been a rise in the incidence of small renal masses (SRM; <4 cm) minimally invasive approaches are becoming more popular in dealing with such pathologies.

Materials and Methods

  • A systematic review of the literature was performed to identify studies comparing LPN and RPN.
  • Comparative studies evaluating RPN and LPN that fulfilled the inclusion criteria were selected.
  • Data on preoperative, operative (operative time, estimated blood loss [EBL], and warm ischaemia time [WIT]), postoperative (length of stay [LOS]) variables and complications were collected.
  • A meta-analysis using random effect model was performed.
  • A further Bland–Altman analysis of some of the operative variables was done to compare their reproducibility and mean difference in techniques.


  • Six studies matched the selection criteria. In all, 256 patients were analysed (40% RPN and 60% LPN).
  • There was no significant different in EBL (P = 0.12, 95% confidence interval [CI] –12.01 to 104.26).
  • Similarly, there was no significant different in WIT between the groups (P = 0.23, 95% CI –15.22 to 3.70).
  • Also, LOS (P = 0.22, 95% CI –0.38 to 0.09) and overall postoperative complication rates were not significantly different between the groups (P = 0.84, 95% CI –0.05 to 0.06).


  • Despite multiple studies reporting better perioperative variables for RPN, the present study found no significant differences between RPN and LPN. This has implications for both the surgeon and the patient.
  • Lack of randomised controlled trials in addition to a lack of long-term oncological data for RPN are current limitations.