LAUSR

Partial nephrectomy (PN) is the standard of care treatment for cT1 renal masses and selected cT2 when technically feasible [1, 2]. Conventional laparoscopic partial nephrectomy can be technically challenging [3, 4]. The advent of robotic assistance allowed the spread of the minimally invasive approach. Robotic-assisted partial nephrectomy (RALPN) is currently considered the gold standard minimally invasive approach for PN by many experts in the field. In the last decade, France witnessed a nationwide increase in the Da VinciTM (Intuitive SurgicalTM, Sunnyvale, CA, USA) robotic system implementations (n = 174) both in public and private institutions. Given this evolving landscape, we aimed to assess the national evolution of renal surgery practices after the introduction of the robotic-assisted surgery. Renal surgery procedures data from 2009 and 2015 were obtained by querying the database of the Agence technique de l’information sur l’hospitalisation (ATIH) hosted by the French Health System. The Common Classification of Medical Procedures (CCAM) was used to extract data of partial nephrectomy (PN) versus radical nephrectomy (RN), open (OPN/ORN) versus laparoscopic (LPN/LRN)/robotassisted (RAPN) surgery. So far, a specific reimbursement coding for RAPN is not available. All minimally invasive PN were coded as LPN including the conventional LPN and RAPN. Da VinciTM System being the unique device available, true conventional LPN was calculated as follows: