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Can robotic surgery conquer partial nephrectomy?

Charles Taylor*, Samyak Jain and Brian Birch.

Robot-Assisted Partial Nephrectomy (RAPN) is fast emerging as a viable alternative to its open and laparoscopic counterparts. When compared to open and laparoscopic approaches, research indicates that RAPN achieves superior outcomes in all three components of the partial nephrectomy trifecta. However, RAPN is associated with several risks and safety concerns that are exclusive to this procedure. This case report presents a seventy-year-old gentleman with unilateral Renal Cell Carcinoma (RCC) for whom a RAPN was planned but who instead underwent an open radical nephrectomy due to significant intraoperative and robotic challenges. This report encourages the critical evaluation of RAPN and emphases the importance of clinical context when deciding on an appropriate surgical modality. This case also illustrates the significance of adequate risk-assessment and mitigation with regards to RAPN and that when applied to inappropriate clinical situations, robot surgery has the potential to be detrimental to patient outcomes.

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