AB019. SOH25_AB_388. Systematic review of robotic transperitoneal vs. retroperitoneal partial nephrectomy: comparative outcomes and surgical approach
Urology Session

AB019. SOH25_AB_388. Systematic review of robotic transperitoneal vs. retroperitoneal partial nephrectomy: comparative outcomes and surgical approach

Ahmed Ahmed, Mohamed Mohamed, Anas Musa, Jamil Malak, Mohamed Zeid, Subhasis Giri

Department of Urology, University Hospital Limerick, Dooradoyle, Limerick, Ireland

Background: Robotic partial nephrectomy (PN) has become the standard of care for nephron-sparing surgery in patients with renal tumors. Two distinct surgical approaches, transperitoneal (TP) and retroperitoneal (RP), are employed based on tumor characteristics, surgeon preference, and institutional expertise. This systematic review aims to compare the outcomes of TP and RP approaches to determine their relative advantages and limitations.

Methods: A comprehensive literature search was conducted across databases (e.g., PubMed, MEDLINE, and Cochrane Library) to identify studies comparing robotic TP and RP PN. Studies were screened based on predefined inclusion and exclusion criteria. Data on operative time, blood loss, complication rates, warm ischemia time, hospital stay, oncological outcomes, and renal function were extracted and analyzed.

Results: The review concluded TP PN was associated with longer operative times but provided superior working space and visualization for anterior tumors. RP PN demonstrated shorter operative times, reduced hospital stays, and quicker recovery, particularly for posterior and lateral tumors. Warm ischemia time and oncological outcomes were comparable between the two approaches, while RP PN was associated with fewer gastrointestinal complications and decreased risk of postoperative ileus.

Conclusions: Both TP and RP approaches to robotic PN are effective and safe, with specific advantages based on tumor location and patient factors. TP PN is preferred for anterior tumors requiring extensive dissection, while RP PN offers a more direct route for posterior and lateral tumors with shorter recovery times. Surgical expertise and patient-specific factors should guide the choice of approach. Further randomized studies are recommended to validate these findings and refine selection criteria.

Keywords: Robotic partial nephrectomy (robotic PN); transperitoneal approach (TP approach); retroperitoneal approach (RP approach); nephron-sparing surgery; renal tumors

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Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab019
Cite this abstract as: Ahmed A, Mohamed M, Musa A, Malak J, Zeid M, Giri S. AB019. SOH25_AB_388. Systematic review of robotic transperitoneal vs. retroperitoneal partial nephrectomy: comparative outcomes and surgical approach. Mesentery Peritoneum 2025;9:AB019.

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