Comparison of Transperitoneal and Retroperitoneal Partial Nephrectomy with Single-Port Robot

To investigate the efficacy and safety of single-port (SP) robotic transperitoneal (TP) and retroperitoneal (RP) partial nephrectomy. We sequentially analyzed 30 partial nephrectomy performed after the SP robot was introduced to the hospital in September 2021 to June 2022. All patients were found to have T1 renal cell carcinoma (RCCs) and were operated by a single expert in conventional robot with da Vinci SP platform. Total of 30 patients underwent SP robotic partial nephrectomy with 16 (53.33%) by TP approach and 14 (47.67%) by RP. Body mass index was slightly higher in TP group (25.37 vs 23.53, p-value = 0.040). The other demographic information was not significantly different. There was no statistical difference in ischemic time (727.41 ± 561.18 seconds for TP and 698.56 ± 299.23 seconds for RP, p-value = 0.812), and console time (67.97 ± 24.06 minutes for TP and 69.71 ± 28.66 minutes for RP, p-value = 0.724). There was no statistical difference in perioperative and pathologic outcomes either. Postoperative renal function calculated from diethylenetriaminepentacetate was 103.33 mL/min/1.73 m² for TP and 101.33 mL/min/1.73 m² for RP (p-value = 0.214). And 90.36 mL/min/1.73 m² for TP and 87.74 mL/min/1.73 m² for RP at 90 days after surgery (p-value = 0.592). SP robot partial nephrectomy can be performed effectively and safely regardless of the approach. TP and RP approach offers similar perioperative and postoperative outcomes for T1 RCC. The Clinical Trial Registration number KC22WISI0431.