Journal article
Single-port vs multi-port robot-assisted renal surgery: analysis of perioperative outcomes for excision of high and low complexity renal masses
Journal of robotic surgery, Vol.17(5), pp.2149-2155
10/01/2023
DOI: 10.1007/s11701-023-01637-4
PMCID: PMC10230457
PMID: 37256454
Abstract
There is emerging but limited data assessing single-port (SP) robot-assisted surgery as an alternative to multi-port (MP) platforms. We compared perioperative outcomes between SP and MP robot-assisted approaches for excision of high and low complexity renal masses. Retrospective chart review was performed for patients undergoing robot-assisted partial or radical nephrectomy using the SP surgical system (
n
= 23) at our institution between November 2019 and November 2021. Renal masses were categorized as high complexity (7+) or low complexity (4–6) using the R.E.N.A.L. nephrometry scoring system. Adjusting for baseline characteristics, patients were matched using a prospectively maintained MP database in a 2:1 (MP:SP) ratio. For high complexity tumors (
n
= 12), SP surgery was associated with a significantly longer operative time compared to MP (248.4 vs 188.1 min,
p
= 0.02) but a significantly shorter length of stay (1.9 vs 2.8 days,
p
= 0.02). For low complexity tumors (
n
= 11), operative time (177.7 vs 161.4 min,
p
= 0.53), estimated blood loss (69.6.0 vs 142.0 mL,
p
= 0.62), and length of stay (1.6 vs 1.8 days,
p
= 0.528) were comparable between SP and MP approaches. Increasing nephrometry score was associated with a greater relative increase in operative time for SP compared to MP renal surgery (
p
= 0.07) using best of fit linear modeling. SP robot-assisted partial and radical nephrectomy is safe and feasible for low complexity renal masses. For high complexity renal masses, the SP system is associated with a significantly longer operative time compared to the MP technique. Careful consideration should be given when selecting patients for SP robot-assisted kidney surgery.
Details
- Title: Subtitle
- Single-port vs multi-port robot-assisted renal surgery: analysis of perioperative outcomes for excision of high and low complexity renal masses
- Creators
- James M. Berry - Washington University in St. LouisHayden Hill - Washington University in St. LouisJoel M. Vetter - Washington University in St. LouisSam B. Bhayani - Washington University in St. LouisGrant M. Henning - Washington University in St. LouisNicholas A. Pickersgill - Washington University in St. LouisArjun Sivaraman - Washington University in St. LouisR. Sherburne Figenshau - Washington University in St. LouisEric H. Kim - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Journal of robotic surgery, Vol.17(5), pp.2149-2155
- DOI
- 10.1007/s11701-023-01637-4
- PMID
- 37256454
- PMCID
- PMC10230457
- NLM abbreviation
- J Robot Surg
- ISSN
- 1863-2491
- eISSN
- 1863-2491
- Publisher
- Springer London
- Number of pages
- 7
- Language
- English
- Date published
- 10/01/2023
- Academic Unit
- Urology
- Record Identifier
- 9984949189302771
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