This study aimed to evaluate the feasibility and perioperative outcomes of robot-assisted laparoscopic partial nephrectomy (RALPN) in patients with high-complexity renal tumors, defined by a R.E.N.A.L. Nephrometry Score (RNS) ≥10

We prospectively enrolled all patients with renal tumors and RNS ≥10 who underwent RALPN at a tertiary hospital in Vietnam, between May 2023 and February 2025. Data collected included demographic characteristics, tumor features, surgical parameters, complications, and oncologic outcomes

Seventeen patients underwent RALPN for high-complexity renal tumors. The mean age was 57.3 years, with a male-to-female ratio of 1.8:1. All tumors were clinically localized, with a mean size of 46.3 mm. No patients had nodal or distant metastases. The mean operative time was 238 minutes, mean warm ischemia time was 29 minutes, and average blood loss was 73 mL. No conversions to open surgery were required. Postoperative stay averaged 6 days. There were four cases of minor complications: two with postoperative fever, one with anemia requiring transfusion, and one with pneumonia without respiratory failure. All patients had negative surgical margins.

RALPN appears to be a safe and feasible minimally invasive option for managing high-complexity renal tumors. Despite technical challenges, oncologic and perioperative outcomes were favorable in this early experience.