Technically challenging, repeat renal surgery has a high morbidity rate. For the treatment of a patient with a history of VHL and multiple previous renal surgeries on the affected kidney, we describe a novel surgical strategy: a salvage robotic transmesenteric off-clamp partial nephrectomy. This procedure is performed to treat a renal cell carcinoma. The specimen was identified as clear cell RCC, Fuhrman Grade 3, with negative surgical margins after pathological examination. The patient recovered quickly and without post-operative complications. In select patients with a significant history of renal surgery and favorable anatomy, this strategy is a viable and safe alternative.