Introduction. Since the first report of laparoscopic nephrectomy by R.V. Clayman in 1991, laparoscopic techniques have become widespread in renal procedures. H.N. Winfield et al. performed the first transperitoneal partial nephrectomy in 1993, while I. Gill et al. described the first retroperitoneal partial nephrectomy one year later. All of the above techniques involved the use of four or more trocars. The fourth (additional) trocar is put for the assistant. There is an opinion that in most cases it is possible to perform partial nephrectomy without an assistant trocar, while maintaining the safety and efficiency of the procedure.
Aim. To compare the safety and efficiency of three-trocar and four-trocar partial nephrectomy.
Materials and methods. Between 2021 and 2023, a total of 200 patients were randomized to three- or four-trocar partial nephrectomy.
Results. There was no difference in the rate of achieving renal trifecta between the two groups. In the three-trocar group, 94 cases of renal trifecta were found, while in the four-trocar group, there were 95 patients with renal trifecta.
Conclusions. The three-trocar technique is not inferior in safety and efficiency to the standard four-trocar technique. The main advantages of the three-trocar technique are less pain, cost and post-operative scarring.

Keywords: surgical technique, laparoscopic ports, trocars, laparoscopic partial nephrectomy