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Summary: Objective: To present our initial peri-operative and pathological outcome data of 23 patients to establish the feasibility of robotic partial nephrectomy (RPN) in a UK cancer centre. Patient and methods: Clinical data from 23 patients who underwent RPN in a single institution between April 2008 and January 2010 were analysed. The RENAL Nephrometry Scoring System was applied to our series. Results: Mean patient age was 54.6 years with a mean tumour size of 2.53cm. The median operative time was 198min and warm ischaemia time (WIT) 30min. There were two conversions and four patients required transfusion, with no other major complications. Histology confirmed renal cell carcinoma in 17 cases. All surgical margins were negative and to date there have been no local or distant recurrences. A mean RENAL score of 5.56 suggested that all the lesions had a low–moderate complexity and were therefore suitable for partial nephrectomy. Conclusion: RPN achieved acceptable WITs, blood loss and complication rates and oncological outcomes. We conclude that this technique is a feasible alternative to open surgery and conventional laparoscopic partial nephrectomy. The urological community need to establish the place for each technique although surgeon preference is likely to be a significant factor. [ABSTRACT FROM AUTHOR]

Summary: There has been much interest in the volume–outcome relationship within surgical specialities and the potential impact on service reconfiguration. Recent research has raised questions about the validity of the methodology used in existing volume–outcome studies. This review explores a methodological framework for assessing the volume–outcome relationship and discusses limitations of previous research. In particular reference is made to the existing urological literature in this field. Areas for improvement and the potential for future research are considered. [Copyright &y& Elsevier]