The difficulty of nephron sparing surgery for large and complex kidney tumor lies in removing tumor completely and reconstructing of large and deep wounds precisely in limited renal ischemia time. The article reported that the experiences of utilizing gradually clamping renal branch arteries by robot-assisted laparoscopic surgery to solve the problem, providing a de-novo option for such kind of complicate operation.

Partial nephrectomy was performed on a case of 56-year-old man with a T2 stage, R.E.N.A.L score of 11 renal tumor by using robot-assisted laparoscopic gradually clamping renal branch arteries surgery technique.

The operation was successfully completed, and organ shape mostly recovered along with normal renal function and no tumor recurrence in one month and halfa year postoperative follow up.

Gradually clamping of renal branch arteries in robot-assisted laparoscopic nephron sparing surgery can be used for large and complex renal mass to ensure complete tumor resection, minimize renal ischemia time and reduce perioperative complications, which deserving the clinical expansion application.