Retroperitoneal Robotic Partial Nephrectomy

Partial nephrectomy (PN) is the standard of care in the treatment of small renal masses. However, significant underutilization remains and most PNs are still performed through an open incision despite greater morbidity and longer recovery (Urology, 67(2):254–9, 2006). Though open PNs are often performed retroperitoneally via the flank, retroperitoneal robotic PN has seen less adoption compared to the transperitoneal approach. Smaller working space and limited anatomic landmarks may present an initial challenge, but the retroperitoneal approach is ideal for posterior or lateral masses, as well as those with prior abdominal operations. Our objective is to provide a detailed illustration of our surgical approach to robotic retroperitoneal partial nephrectomy (BJU Int, 114(2):311–3, 2014).