INTRODUCTION

This study aims at examining the trends in practice and outcomes of robot-assisted partial nephrectomy (RAPN) in the UK.

Materials and Methods
Retrospective analysis was performed of RAPN cases submitted from 2013-2016 to the British Association of Urologic Surgeons (BAUS) nephrectomy database. This included number of hospitals and consultants performing RAPN, patient characteristics and perioperative investigations and outcomes. Statistical significance was calculated using the t- and chi-squared tests via SPSS.

RESULTS

A total of 2074 RAPNs were performed during this period with an annual increase in the number of operations performed. There was a general increase in the number of hospitals and consultants providing RAPN. Patient age, body mass index and percentage of males did not change. There was a statistically significant (p<0.05) decrease in the operating time, mean blood loss, transfusion rate, rate of complications, intensive care unit admissions and hospital length-of-stay. There was a statistically significant (p<0.05) increase in the implementation of zero ischaemia, mean warm ischaemia time and day-one and same-day discharges. Although there was an increase in pre-operative biopsies performed, that did not change the percentage of renal masses deemed benign on post-operative specimen analysis.

Conclusions
RAPN is being increasingly implemented in the UK. Reporting surgeon-volume and hospital-volume outcomes may be used to aid centralization or reconfiguration of surgical services. Better recording of outcomes might improve the quality of the analysis by limiting missed data.