**6. Indication and guidelines**

Both EAU and AUA guidelines advise minimally invasive surgery if possible, however advise caution if perioperative, oncological or functional outcomes are at risk of compromise [32, 33]. In fact, EAU recommend partial nephrectomy over radical in patients with T1 tumours, even if an open approach is warranted. Any approach for PN is valid based on the surgeons skill and preference.

The EAU advise that despite the similar cancer specific survival and recurrence free survival for pT1 tumours in the comparison of partial versus radical nephrectomy; partial nephrectomy is still the ideal treatment in view of minimising impairment to renal function and preventing metabolic and cardiovascular disorders in the long term. Retrospective studies have revealed no difference in long term overall and cancer specific survival between laparoscopic and open partial nephrectomies [34, 35].

Prospective comparison of robotic-assisted versus open partial nephrectomy found significant improvement in estimated blood loss and length of stay in the cohort undergoing RAPN. Early and short term complications, operative time and warm ischaemia time were similar between both approaches [36]. Robotic-assisted surgery was found be superior to laparoscopic PN with regards to conversion to open, conversion to radical nephrectomy, warm ischaemia time and length of stay. This meta-analysis of 23 studies also concluded no difference in short term postoperative complications, operative time, estimated blood loss and positive margins [37].
