Abstract：Objective: To explore the clinical application and experience of precise robotic radical nephrectomy (RRN) through a transperitoneal approach. Methods: We retrospectively reviewed the records of patients who underwent RRN by the same surgeon at our institute from February 2016 to November 2016. Four robotic arms (one camera arm and three operation arms) were applied, and one assistant trocar was used for left kidney tumors as well as two for right ones. Twenty-four patients (20 males and 4 females) with a mean age of 55 (22-73) years old whose preoperative demographics, intraoperative parameters, postoperative parameters and complications were recorded and the operation experience was summarized. Results: All the operations were successfully completed with no convertion to open surgery. The mean operation time was (122.46±22.55) min (80-184 min). The mean blood loss was 65 (20-400) mL. The mean length of hospital stay was (7.08±1.56) d. Tumors in 7 cases were located in the left kidney and those in 17 cases in the right one. The mean maximum tumor diameter was (4.40±1.20) cm (2-7 cm). Pathological results showed that there were 21 cases of clear cell carcinoma, 1 case of oncocytoma, 1 case of papillary renal cell carcinoma, and 1 case of Xp11.2 translocation/TF3 fusion gene-related renal cell carcinoma. Conclusions: The application of scientificly and precisely designed surgical procedures to the RRN has the advantage of shorter operation time, less blood loss, less postoperative complications and higher safety. It can shorten the learning curve and provide urologists an effective surgical procedure for reference.
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