A 72-year-old male with multiple comorbidities, including hypertension, type 2 diabetes, and a history of coronary artery disease (post-PTCA) and aortic valve replacement, was incidentally found to have a small right renal mass during routine evaluation. The lesion was located at the posterior mid-pole of the kidney, a challenging location for conventional surgery.
Contrast-enhanced imaging demonstrated a well-circumscribed exophytic lesion measuring 2.1 × 1.9 × 1.8 cm. The RENAL nephrometry score was 6p, indicating a low-complexity posterior renal tumor suitable for nephron-sparing surgery. No evidence of local invasion or metastasis was noted.
Given the patient’s comorbidities and tumor location, a robotic-assisted partial nephrectomy was planned. The robotic platform offered high-definition 3D visualization, precise instrument control, and superior dexterity, which facilitated safe excision of the posteriorly located tumor while preserving healthy renal parenchyma.
The patient had an uneventful postoperative recovery. He was mobilized on the same day, tolerated oral intake, and required only mild analgesics. Discharge was on postoperative day 2. Histopathological examination confirmed complete tumor excision with negative margins, reflecting successful oncological and functional outcomes. Follow-up imaging and renal function tests remained normal, demonstrating the effectiveness and safety of robotic-assisted nephron - sparing surgery for posterior renal masses.
This case reinforces that small renal masses, even in challenging posterior locations, can be safely managed with nephron-sparing surgery using robotic assistance, offering precise tumor excision, excellent preservation of renal function, and favorable oncological outcomes.
Treating Surgeon: Dr. Devendra Sharma
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