The aim of this study was to compare the outcomes of robotic-assisted partial nephrectomy (RAPN) and 3D-laparoscopic partial nephrectomy (3D-LPN) for the management of renal tumors, focusing on perioperative variables, postoperative recovery, and long-term oncological and functional results.

We conducted a retrospective analysis of renal tumor patients who underwent RAPN or 3D-LPN at our institution. Outcomes evaluated included operative time, blood loss, length of hospital stay, complication rates, and positive margin rate

The mean warm ischemia time was significantly shorter in the robotic PN group (22.40 ± 8.0 minutes) compared to the 3D-laparoscopic PN group (40.49 ± 7.3 minutes, p < 0.05). Estimated blood loss showed a trend toward lower values in the robotic PN group (189.5 ± 35 ml) compared to the 3D-laparoscopic PN group (258.8 ± 28 ml), though this difference was not statistically significant (p = 0.057). Conversely, operation time was significantly longer in the robotic PN group (282.17 ± 60 minutes) compared to the 3D-laparoscopic PN group (205.24 ± 71 minutes, p < 0.05).

These findings suggest that while robotic PN may offer advantages in reducing warm ischemia time and potentially blood loss, it is associated with longer operative durations compared to 3D-laparoscopic PN. Complex tumors with a RENAL score between 7 and 9 and posteriorly located tumors can be better excised with RAPN