Single-Port Versus Multi-Port Robotic Retroperitoneal Partial Nephrectomy: A Propensity Score-Matched Comparison

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Retroperitoneal partial nephrectomy (PNx) is a standard procedure for small renal masses.
• Robotic assistance has enhanced the precision and outcomes of PNx.
• Advancements in robotic technology include single-port (SP) and multi-port (MP) systems.

Purpose of the Study:

• To compare the surgical outcomes of retroperitoneal (RP) robot partial nephrectomy (PNx) using single-port (SP) versus multi-port (MP) robotic systems.
• To evaluate the feasibility and efficacy of SP robot RP PNx.
• To identify potential advantages of SP over MP robotic PNx.

Main Methods:

• Retrospective review of 125 patients undergoing RP robotic PNx from September 2021 to April 2023.
• Patients were divided into two groups: 81 treated with MP robot (da Vinci Xi) and 44 with SP robot (da Vinci SP).
• Propensity score-matching (PSM) analysis was performed to minimize confounding factors.

Main Results:

• After PSM, no significant differences were observed in operation time, console time, or estimated blood loss between SP and MP groups.
• A statistically significant difference was found in warm ischemia time, with the SP group (13.82 ± 4.59 min) showing a shorter duration than the MP group (17.18 ± 6.56 min) (p=0.007).
• No other significant differences in surgical outcomes were noted between the two robotic approaches.

Conclusions:

• Single-port (SP) robot retroperitoneal partial nephrectomy (PNx) achieves comparable surgical outcomes to multi-port (MP) robot PNx.
• SP robot RP PNx presents a viable and potentially more convenient surgical option, especially for small renal masses located posteriorly.
• The findings support the consideration of SP robot RP PNx as an effective alternative to conventional MP robotic procedures.