Challenging Situations in Robotic Partial Nephrectomy

Growing experience of partial nephrectomy has enabled surgery to be offered to patients previously considered too complex. Prior abdominal surgery can greatly increase the complexity of a partial nephrectomy and requires careful preoperative and intraoperative planning. Horseshoe kidneys may be complicated by aberrant vascular anatomy particularly if a heminephrectomy is required. The two primary aims in managing single functioning kidney are to gain oncological control and maintain sufficient renal function. The safe management of complex patients requires a well-planned, multidisciplinary approach by teams experienced in treating such patients.