Practical surgical techniques and future perspectives of robot-assisted complex partial nephrectomy

doi:10.3877/cma.j.issn.1674-3253.2026.01.004

Abstract

Abstract:

Renal cell carcinoma (RCC), a prevalent urological malignancy globally, has seen significant shifts in its therapeutic strategies in recent years. With advancements in minimally invasive surgery, robotic-assisted systems have become crucial tools in partial nephrectomy for RCC. This review discusses the use of robotic technology in RCC partial nephrectomy, summarizing its advantages, practical techniques, clinical efficacy, challenges, and future perspectives.

Key words: Robotic-assisted, Renal cell carcinoma, Partial nephrectomy

Zijie Li, Wei Wang, Zhengfei Hu. Practical surgical techniques and future perspectives of robot-assisted complex partial nephrectomy[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(01): 22-33.

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肿瘤位置	经腹腔入路	腹膜后入路
上极肿瘤	游离肾上腺（保留中央静脉），游离面紧贴肾上腺，局限性切除肿瘤表面肾周脂肪（防粘连）	保留Gerota筋膜背侧脂肪，维持筋膜屏障，仅剥离肾上极脂肪，避免进入胸膜腔
肾门肿瘤	优先分离十二指肠/胰尾，精准切除肿瘤表面肾周脂肪（保护门脉结构）	保留肾窦脂肪垫，预防淋巴瘘，直接暴露血管（避免腹膜返折损伤）
下极肿瘤	识别并保护结肠旁沟血管，切除肿瘤远端脂肪并保留输尿管系膜脂肪（防缺血）	避免广泛切除背侧脂肪，避开生殖血管

肿瘤位置	经腹腔入路	腹膜后入路
上极肿瘤	游离肾上腺（保留中央静脉），游离面紧贴肾上腺，局限性切除肿瘤表面肾周脂肪（防粘连）	保留Gerota筋膜背侧脂肪，维持筋膜屏障，仅剥离肾上极脂肪，避免进入胸膜腔
肾门肿瘤	优先分离十二指肠/胰尾，精准切除肿瘤表面肾周脂肪（保护门脉结构）	保留肾窦脂肪垫，预防淋巴瘘，直接暴露血管（避免腹膜返折损伤）
下极肿瘤	识别并保护结肠旁沟血管，切除肿瘤远端脂肪并保留输尿管系膜脂肪（防缺血）	避免广泛切除背侧脂肪，避开生殖血管

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