Single institution experience with robot-assisted laparoendoscopic single-site renal procedures

Area of Science:

• Minimally Invasive Surgery
• Urologic Oncology
• Robotic Surgery

Background:

• Laparoendoscopic single-site (LESS) surgery aims to reduce morbidity associated with multiple port sites.
• Challenges in LESS, such as instrument clashing and loss of triangulation, have limited its adoption.
• Robotic platforms are being adapted to overcome LESS limitations in single-site surgery.

Purpose of the Study:

• To review institutional experience with robot-assisted LESS renal surgery.
• To summarize current literature on robot-assisted LESS kidney procedures.
• To assess the feasibility and outcomes of robotic LESS in urology.

Main Methods:

• Review of 28 robot-assisted LESS kidney procedures from a prospectively maintained database.
• Procedures included nephrectomies, nephroureterectomies, pyeloplasties, and renal cyst decortication.
• Analysis of perioperative and postoperative data, including follow-up and oncologic outcomes.

Main Results:

• Four conversions occurred in 28 cases; remaining procedures used no extra trocars.
• Positive oncologic outcomes observed: negative margins and disease-free status for radical nephrectomy, partial nephrectomy, and nephroureterectomy.
• Significant symptom resolution or improvement reported for pyeloplasty patients.

Conclusions:

• Robot-assisted LESS kidney surgery is feasible for a wide range of urologic procedures.
• This approach demonstrates potential for effective oncologic control and symptom management.
• Further long-term follow-up is necessary to confirm oncologic efficacy and durability.