AUA 2018: Open, Laparoscopic And Robotic Partial And Radical Nephrectomy: Practice Patterns And The New Standard Of Care

San Francisco, CA USA ( During recent years, robot-assisted surgery has become increasingly available as more hospitals have found funds and reason to acquire a daVinci. Dr. Palsae and colleagues set out to determine practice patterns and dissemination of robotic partial nephrectomy and radical nephrectomy. The study team compared these to their open and laparoscopic counterparts. Dr. Palsae and colleagues performed a retrospective chart review of 26152 patients who underwent robotic partial nephrectomy between 2008 and 2016, using the Statewide Planning and Research Cooperative database.

Patients were broken down into eight health service areas and patients were determined to be traveling if they had to leave their health service area and receive treatment from anther health service area within the state of New York. During the study period time, proportion of robotic surgeries increased in both types from 18.5% to 51.1% in partial nephrectomy and 3.7% to 23% in radical nephrectomy. Utilization of both open and laparoscopic has remained stable in both across the study period.

The study also reports that the proportion of hospitals performing robotic partial and radical nephrectomies has increased from 22 to 57 and 18 to 49, respectively. With the increase of hospitals performing robotic procedures, the proportion of patients traveling for procedures has decreased from 39.3% to 22% for partial and 35.9 to 23.5% for radical nephrectomy.
Even considering the above information, there were still not significant changes between the open and laparoscopic approaches among these hospitals. In conclusion, the dissemination of the use of robotic and partial nephrectomy techniques has been increasing from 2008 to 2015, resulting in very minimal decline in open and laparoscopic approaches. Additionally, the study team notes that regional uptake of robotic practices has been increasing, as evident by the increase in the number of hospitals and decreased number of patients traveling from these procedures.

Presented by Michael Palese

Written by: Anthony Warner, AS, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA