本研究旨在描述机器人辅助部分肾切除期间一种新颖的肾实质缝合策略。该技术分为关键步骤。通过双层技术完成肾实质缝合。外层肾实质缝合的新策略是使用2-0维克睛线采用锯齿形方式接近实质边缘进行缝合。每次穿刺均紧贴出口处开始，通过缺陷并用Hem-o-lok夹子固定退出线。在每个退出处，使用Hem-o-lok夹子固定缝线。在松弛的结尾处放置第二个Hem-o-lok夹子，将缝线拉紧到夹子锁定机构中。本研究包括2017年1月至2022年1月在单个机构接受机器人辅助部分肾切除的连续159例患者。分析基线特征、手术、病理和肿瘤学结果的描述性统计学。其中103例(64.8%)患者出现T1a期的肾实质肿块。总手术时间中位数(四分位数[IQR])为146(120-182)分钟。未出现开放手术转化，但有5例(3.1%)患者转化为根治性肾切除。我们报告了术后并发症的整体低发生率。发现5例周围肾血肿和6例尿液泄漏(2例T2a期，2例T1b期，2例T1a期肾细胞癌)。在有经验的医生操作中，Z字形技术是外层肾实质缝合的可行且安全的替代方案。需要未来的比较研究来确认我们的结果。

The aim of this study was to describe a novel outer layer renorrhaphy strategy during robot-assisted partial nephrectomy.This technique is presented in key steps. Renorrhaphy is performed with a double layer technique. The novel strategy of outer layer renorrhaphy is to approach the parenchymal margins in a zigzag-shaped manner with a 2-0 Vicryl running suture. Each pass begins immediately adjacent to the exit site. The needle is passed through the defect and the exiting suture is secured with a Hem-o-lok clip. At each exit site, the suture is secured with a Hem-o-lok clip. A second Hem-o-lok clip is placed at the loose ends, to tighten the suture in the clip locking mechanism. Patients submitted to robot-assisted partial nephrectomy at a single institution between January 2017 and January 2022 were included in the analysis. Descriptive statistics of baseline characteristics and surgical, pathological, and oncological outcomes were analyzed.One hundred fifty-nine consecutive patients were recorded; 103 (64.8%) of them presented with a cT1a renal mass. Median (interquartile range [IQR]) total operative time was 146 (120-182) minutes. There was no conversion to open surgery, while 5 (3.1%) patients were converted to radical nephrectomy. We reported an overall low rate of postoperative complications. There were 5 documented perirenal hematomas and 6 cases of urinary leakage (2 pT2a, 2 pT1b, 2 pT1a renal cell carcinoma).Z-shaped technique is a feasible and safe alternative for renorrhaphy of the outer layer, in experienced hands. Future comparative studies are needed to confirm our results.