Introduction: The diagnosis of small renal masses and the endophytic tumor approach have become challenging. This study aims to describe exclusively robot-assisted surgery as an alternative nephron-sparing approach for renal intraparenchymal tumors. Patients and Methods: We retrospectively analyzed all patients with completely endophytic tumors undergoing robot-assisted partial nephrectomy, treated under the Da Vinci System®, aided by intraoperative ultrasound. The patients’ demographic characteristics, perioperative and oncological outcomes were assessed. Results: From a total of 13 partial nephrectomies performed between 06/2010 and 10/2021, all patients underwent nephrotomy. The patients’ mean age was 52 years and the tumor measured mean 2.6 cm. Warm ischemia time was 24 minutes and histopathological analysis revealed that 12 patients had renal cell carcinoma. In a mean 36-month follow-up, no significant renal function alterations were found and no local or systemic recurrences occurred. Conclusion: Robot-assisted access is a safe and effective option for the nephron-sparing technique in completely intraparenchymal renal tumors.
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