目的:总结经后腹腔入路机器人辅助后腹腔镜肾部分切除术(RPRPN)的手术经验和临床疗效。方法:回顾性分析2013年12月~2015年12月接受RPRPN手术的189例患者的临床资料。对RPRPN手术术前准备、机器人摆置,操作通道设计进行描述,对其中关键步骤和技术要点进行经验总结,同时对患者年龄、体质指数(BMI)、中位肿瘤最大径、肿瘤位置、术中估计失血量、热缺血时间、手术时间、术后切缘病理及术后并发症情况等进行统计学分析。结果:189例手术均成功完成,无一例中转开放手术。手术时间60~105min,平均(76.13±2.79)min,术中估计出血量10~130ml,平均(61.14±8.51)ml;术中阻断肾动脉热缺血时间9~31 min,平均(15.24±0.62)min,术后均留置引流管,术后1~6(4.49±0.26)d拔出引流管即可下床活动;术后住院时间4~7d,平均(6.13±0.13)d。术后病理结果提示肾透明细胞癌161例,血管平滑肌脂肪瘤12例,多房囊性肾癌7例,乳头状肾细胞癌5例,肾嫌色细胞癌2例,其他2例。其中切缘阳性0例。术中9例改为根治性肾切除术,6例术中出血>400 ml,予以输血。术后中度以上肾功能不全3例,2例出现心房颤动,1例出现心肌梗死,1例尿漏,术后5例出血>400ml,1例行肾根治性切除术,2例行血管介入栓塞治疗,3例出现动静脉瘘行介入栓塞治疗。无一例患者术后死亡。平均随访11(2~28)个月,随访期内,1例肿瘤复发,无死亡病例。结论:后腹腔入路机器人肾部分切除术安全可行,对于处理肾背侧、肾上极、背侧肾门等位置的肿瘤较经腹腔入路操作更有优势,值得应用和推广。 Objective: To summarize the surgical experience and clinical effects of retroperitoneal laparoscopic partial nephrectomy (RPRPN) by retroperitoneal approach robot. Methods: The clinical data of 189 patients who underwent RPRPN between December 2013 and December 2015 were analyzed retrospectively. The preoperative preparation of RPRPN, placement of robots and the design of operation channel were described, and the key steps and technical points were summarized. At the same time, the patients’ age, body mass index (BMI), median tumor diameter, tumor location, intraoperative Estimated blood loss, warm ischemia time, operation time, postoperative pathology and postoperative complications were statistically analyzed. Results: All the 189 surgeries were completed successfully. None of them underwent open surgery. The mean operative time was 60 ~ 105min (mean, 76.13 ± 2.79) min. The intraoperative blood loss was estimated as 10 ~ 130ml (61.14 ± 8.51) ml. The duration of intraoperative ischemia was 9 ~ 31 min 0.62) min. After operation, the drainage tube was placed and the drainage tube was pulled out after 1 ~ 6 (4.49 ± 0.26) d after operation. The postoperative hospital stay was 4 ~ 7 days with an average of (6.13 ± 0.13) days. Postoperative pathologic findings prompted 161 cases of clear cell renal cell carcinoma, 12 cases of angiomyolipoma, 7 cases of polycystic kidney disease, 5 cases of papillary renal cell carcinoma, 2 cases of chromophobe renal cell carcinoma and 2 cases of other cases. The positive edge of 0 cases. Intraoperative change to radical nephrectomy in 9 cases, 6 cases of intraoperative bleeding> 400 ml, to be transfused. Postoperative moderate renal insufficiency in 3 cases, 2 cases of atrial fibrillation, 1 case of myocardial infarction, 1 case of urinary leakage, 5 cases of bleeding> 400ml, 1 case of radical nephrectomy, 2 cases of vascular intervention Embolization, 3 cases of arteriovenous fistula interventional embolization. No patient died after surgery. The average follow-up was 11 (2-28) months. During the follow-up period, one patient had a tumor recurrence without any death. Conclusion: The transabdominal cavity partial nephrectomy is safe and feasible. It is more suitable for the treatment of tumors with renal dorsal, superior pole and dorsal renal portal, which is worthy of application and promotion.