This study conducts a comparison of perioperative and postoperative outcomes between two groups of patients with suspicious renal masses undergoing RPN (Robotic Partial Nephrectomy) or LPN (Laparoscopic Partial Nephrectomy). Furthermore, we compared the rates of achievement of trifecta as well as “optimal outcome”. We have retrospectively collected data from the patient database of A/Prof Homayoun Zargar, a surgeon with extensive training and significant expertise in both LPN and RPN.

A total of 216 patients underwent partial nephrectomy from 2017 to 2025 and were reviewed for this study. Patients were divided into two groups based on whether they underwent an RPN or an LPN. Trifecta was defined as WIT (Warm Ischemia Time)<25, Negative margins and no post-op complications. Optimal outcome was defined as achievement of Trifecta as well as short term (3 months) eGFR preservation of >90%. Statistical analysis was carried out using GraphPad Prism, version 10.4. This study was limited to cases performed by a single surgeon with significant expertise in both RPN and LPN.

A total of 136 patients who underwent robotic-assisted partial nephrectomy (RPN) and 80 patients who underwent laparoscopic partial nephrectomy (LPN) were included in the study. The RPN and LPN groups demonstrated comparable median age (61 vs. 58 years), tumor size (32 mm vs. 31 mm), and R.E.N.A.L. score (8.0 vs. 8.0). Warm ischemia time (WIT) was evaluated in both groups, with 47 RPN patients and 34 LPN patients having a WIT of 0. The median WIT did not differ significantly between RPN and LPN (10 min vs. 8 min, p = 0.6802). Negative surgical margin rates (93.60% vs. 86.11%, p = 0.1210), complication rates (5.88% vs. 6.25%, p = 0.5646), and the rate of eGFR preservation >90% (77.59% vs. 77.92%, p = 0.9999) were also comparable between the two groups. Postoperative complications were further analysed using the Clavien-Dindo classification, with a median Clavien grade of 1 in the RPN group compared to grade 3 in the LPN group. Finally, the rate of achieving trifecta (83.09% RPN vs 77.78% LAP, p-value = 0.3719) and optimal outcome (69.85% RPN vs 64.20% LAP, p-value = 0.4532) showed no difference between both groups.

There was no statistically significant difference in the rate of achieving the trifecta or optimal outcomes among both groups. Also, both the RPN and the LPN groups demonstrated comparable outcomes across all criteria used in defining the trifecta. These findings suggest that both RPN and LPN are equally effective and safe when performed by an experienced surgeon.