Minimizing Ports During Robotic Partial Nephrectomy.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Standard robotic upper urinary tract surgery typically uses a 5-port configuration.
• Fewer ports may lead to less invasive surgical procedures.

Purpose of the Study:

• To report a novel technique for robot-assisted partial nephrectomy using fewer ports.
• To evaluate the feasibility and safety of this reduced-port approach.

Main Methods:

• Retrospective analysis of 11 robot-assisted laparoscopic partial nephrectomies.
• Utilized the DaVinci Xi robotic platform with a 3-arm setup.
• Employed the AirSeal system for simultaneous instrument introduction, obviating an additional port.

Main Results:

• Mean patient age 55 years, BMI 29.18.
• Mean tumor size 32.45 mm.
• Average surgical time 132.2 minutes, estimated blood loss 103.63 mL, ischemia time 16.72 minutes.
• One case of postoperative bleeding resolved without transfusion.
• Median hospitalization 3.9 days.
• Stable intra-abdominal pressure maintained at 10 mm Hg.

Conclusions:

• The AirSeal System's valveless trocar enabled a reduced-port technique.
• The described method is feasible, safe, and reproducible for selected robot-assisted partial nephrectomies.