Single Port Modified Partial Nephrectomy: Novel Simultaneous Access to Peritoneal and Retroperitoneal Partial...

Area of Science:

• Urologic surgery
• Minimally invasive surgery
• Robotic surgery

Background:

• The DaVinci single port (SP) robotic platform, FDA-approved in 2018, is increasingly used for urologic procedures.
• The lower anterior access (LAA) incision offers a versatile entry point for SP robotic surgery, facilitating both transperitoneal and retroperitoneal approaches.

Purpose of the Study:

• To evaluate the early intraoperative and perioperative outcomes of single port robot-assisted partial nephrectomy (SP-RAPN) using a lower anterior access (LAA) incision.
• To assess the potential benefits and feasibility of the LAA incision for SP-RAPN.

Main Methods:

• A prospective review of 78 SP-RAPN cases performed between March 2021 and January 2023.
• A single 2-3 cm oblique LAA incision was utilized for port insertion.
• Intraoperative and perioperative data were collected and analyzed.

Main Results:

• SP-RAPN was successfully completed in all 78 patients without conversion to open or laparoscopic surgery.
• The average operating time was 90.5 minutes, with an average estimated blood loss of 88.3 mL.
• The average length of hospital stay was 1.07 days, and no complications were reported.

Conclusions:

• The lower anterior access (LAA) incision is a feasible, reproducible, and safe approach for SP-RAPN.
• This standardized incision facilitates seamless transition to retroperitoneal approaches using the SP platform.