Single-Port Partial Nephrectomy: State of the Art and Future Directions

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Partial Nephrectomy (PN) is the standard for localized renal masses, with robotic surgery enhancing minimally invasive approaches.
• Single-Port (SP) robotic systems aim to reduce invasiveness and improve recovery through a single incision.
• SP-RAPN has shown early promise, with results comparable to Multi-Port (MP) robotic surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of Single-Port Robot-Assisted Partial Nephrectomy (SP-RAPN).
• To compare SP-RAPN outcomes with traditional Multi-Port RAPN (MP-RAPN).
• To explore the benefits of specific surgical approaches like the retroperitoneal route and Lower Anterior Access (LAA).

Main Methods:

• Comparative analysis of SP-RAPN and MP-RAPN perioperative, oncological, and functional outcomes.
• Evaluation of different surgical access routes, including retroperitoneal and LAA.
• Review of early experiences and technological advancements impacting SP-RAPN.

Main Results:

• SP-RAPN demonstrates comparable oncological and functional results to MP-RAPN.
• SP-RAPN offers advantages in reduced invasiveness, improved cosmetic outcomes, and shorter hospital stays.
• Retroperitoneal and LAA approaches show anesthesiological and surgical benefits, though SP-RAPN may have slightly longer Warm Ischemia Times (WITs).

Conclusions:

• SP-RAPN is a safe and feasible advancement in nephron-sparing surgery.
• The retroperitoneal and LAA approaches enhance perioperative benefits.
• Patient selection, training, and technological advancements are key to optimizing SP-RAPN's role in urologic surgery.