In September 2019, the French High Authority for Health (HAS) published an assessment report on the evaluation of total or partial robotic-assisted nephrectomy. This is the second indication for robotic surgery to be evaluated; the first one was for radical prostatectomy.
The aim of this work was the evaluation of the efficacy and the safety of robot-assisted nephrectomy, compared to open surgery and conventional laparoscopic surgery, in order to assess the justification of its inclusion in the standard classification of medical procedures (CCAM) to allow its reimbursement by the health insurance.
The report focused on three different clinical contexts: partial nephrectomy in kidney cancer, total nephrectomy in kidney cancer, and total nephrectomy for kidney removal in transplantation.
The work consisted of assessing the quantity and quality of the available data, based on a systematic literature search, supplemented by a consultation of stakeholders concerned by the technique.
The following conclusions were provided by HAS:
- Regardless of the use of the studied robot-assisted nephrectomy or the comparison (vs. open surgery or traditional laparoscopic surgery), the available literature review did not identify any prospective comparative studies reporting robust results with relevant judgment criteria and collected with appropriate follow-up time
- The stakeholder interviews confirmed this analysis, which shows that the available data do not meet the conditions set out in the HAS to allow an evaluation of assisted-robot nephrectomy
- As a result, HAS cannot comment on the expected service or the expected service improvement of robot-assisted nephrectomy compared to open surgery or conventional laparoscopic surgery
See the full health technology assessment report in French here.
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