Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney. Treatment approaches depend on tumor size, location, renal function, and overall patient health. Traditionally, radical nephrectomy (RN) has been considered the standard treatment, but with growing recognition of the importance of preserving renal function, partial nephrectomy (PN) has become increasingly favored, especially for small renal masses (≤4 cm, T1a) and select larger tumors (T1b). Enucleation is a specialized technique used in PN, where the tumor is carefully dissected along its natural plane, preserving as much normal renal parenchyma as possible.

In this one take video, a 60-year-old male with an incidentally detected right renal tumor (measuring 4.2 × 4.6 × 4.1 cm, cT1b) underwent robotic partial nephrectomy with enucleation technique by first year attending urologist. The RENAL nephrometry score was 8p (R-2, E-1, N-3, P, L-2).

Enucleation was completed in 8 minutes. The pathological report confirmed pT1bNx (AJCC 8th), clear cell renal cell carcinoma, grade III, with negative surgical margins. The patient tolerated the procedure well and was discharged on postoperative day 5 without complications or significant morbidity. A 4-month follow-up abdominal CT showed no recurrence.

Enucleation is an effective nephron-sparing surgical technique in partial nephrectomy, providing excellent renal function preservation while maintaining oncological safety in appropriately selected patients. Its advantages in reducing ischemic injury and preserving functional nephrons make it a valuable approach. However, careful case selection and surgical expertise are crucial for ensuring optimal outcomes.