Recommendation for NHSScotland

Evidence is of insufficient quality to reach conclusions on the comparative clinical effectiveness and long-term cost effectiveness of robot assisted laparoscopic partial nephrectomy, open partial nephrectomy and conventional laparoscopic partial nephrectomy. Reported benefits for the robotic procedure are based on short-term non-randomised studies which do not report long-term clinical outcomes. In a single retrospective UK study the robot assisted laparoscopic procedure was associated with a statistically significant reduction in the costs associated with 90-day complication rates and 1-year hospital activity when compared with open partial nephrectomy.

What were we asked to look at?

What is the clinical and cost-effectiveness of robot assisted laparoscopic partial nephrectomy compared with open or conventional laparoscopic procedures in patients with
T1a or T1b renal cancer? 

Why is this important?

Da Vinci robotic surgical devices are a relatively new technology which is available at three centres in NHSScotland. These devices are currently used predominantly to
provide a laparoscopic prostatectomy service. To ensure the devices are optimally employed, NHSScotland is considering expanding the indications for which robotic
surgery is available. This work was accepted onto the SHTG programme as a priority, to support evidence-informed use of robotic surgery capacity.

Referred by

West of Scotland Cancer Network