| Summary: | <b>(1) Background</b>: Laparoscopic partial nephrectomy (LPN) is still performed in many referred urological institutions, representing a valid alternative to robot-assisted partial nephrectomy (RAPN). We aimed to compare trifecta outcomes of LPN and RAPN with the Hugo™ RAS System. <b>(2) Methods</b>: Between October 2022 and September 2023, eighty-nine patients underwent minimally invasive partial nephrectomy (group A, RAPN = 27; group B, Laparoscopic PN = 62) for localized renal tumors at our Institution. Continuous variables were presented as median and IQR and compared by means of the Mann–Whitney U test, while categorical variables were presented as frequencies (%) and compared by means of the χ<sup>2</sup> test. <b>(3) Results</b>: Group A showed a higher rate of male patients (81.5% vs. 59.7%, <i>p</i> = 0.04) and a higher trend towards larger clinical tumor size (34 vs. 29 mm, <i>p</i> = 0.14). All the other baseline variables were comparable between the two groups (all <i>p</i> > 0.05). Regarding post-operative data, group A displayed a lower operative time (92 vs. 149.5 min, <i>p</i> = 0.005) and a shorter hospital stay (3 vs. 5, <i>p</i> = 0.002). A higher rate of malignant pathology was evidenced in group A (77.8% vs. 58.1%, <i>p</i> = 0.07) as well as a lower trend towards positive surgical margins (3.7% vs. 4.8%, <i>p</i> = 0.82), even if not statistically significant. <b>(4) Conclusions</b>: The rate of trifecta achievement was 92.6% and 82.3% for group A and B (<i>p</i> = 0.10), respectively. In terms of trifecta outcomes, RAPN using the Hugo™ RAS System showed comparable results to LPN performed by the same experienced surgeon.
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