A bibliometric analysis of the most-cited studies on robotic nephrectomy versus laparoscopic nephrectomy: Citation trends and scientific influence.

Abstract

Robotic nephrectomy has emerged as an alternative to laparoscopic nephrectomy, offering enhanced surgical precision, reduced blood loss, and faster recovery. However, its clinical effectiveness and cost-efficiency remain debated. This study aims to perform a bibliometric analysis of the 100 most-cited publications comparing robotic and laparoscopic nephrectomy, focusing on clinical, technological, and economic aspects. A bibliometric search was conducted in the Scopus database on July 26, 2025, using the keywords "robotic nephrectomy" AND "laparoscopic nephrectomy" AND "human". Articles were sorted by citation count and screened based on clinical relevance. The top 100 most-cited studies were selected, and data on authorship, institutions, countries, journals, and keywords were extracted. A total of 435 publications from 43 countries were identified, with the United States leading in publication count (n=110) and citations (n=2,497), followed by China and Italy. The studies showed comparable oncologic outcomes (positive surgical margin, 1.6%-5.4%; 3-year disease-free survival, up to 94.9%), with robotic-assisted partial nephrectomy (RAPN) associated with improved perioperative outcomes, including shorter warm ischemia time, lower blood loss, and fewer complications (odds ratio, 0.55). Functional outcomes favored RAPN, particularly in complex tumors (estimated glomerular filtration rate, 96% vs. 90%), though robotic approaches were more costly. Robotic nephrectomy offers perioperative and functional advantages with comparable oncologic outcomes to laparoscopic approaches, though at higher cost. This bibliometric analysis provides clinical implications for decision-making and highlights the growing support for RAPN, emphasizing the need for high-quality prospective studies to guide future research.