Comparing incisional hernia risk between single-port and multiport robot-assisted partial nephrectomy: a...

Area of Science:

• Urology
• Surgical Oncology
• Abdominal Surgery

Background:

• Incisional hernia (IH) is a known postoperative complication following abdominal surgery.
• The incidence of IH after robotic-assisted partial nephrectomy (RAPN), particularly the single-port (SP) approach, remains understudied.
• Understanding IH risk factors is crucial for patient selection and surgical technique optimization.

Purpose of the Study:

• To evaluate the incidence of incisional hernias (IH) after single-port (SP) robotic-assisted partial nephrectomy (RAPN).
• To compare the factors influencing IH development between SP and multiport (MP) RAPN.
• To identify specific risk factors associated with IH in different surgical approaches.

Main Methods:

• Retrospective analysis of patients undergoing MP and SP RAPN.
• Exclusion criteria included less than 6 months follow-up, concomitant procedures, conversion to open or radical nephrectomy, and prior IH.
• Statistical analysis, including multivariable logistic regression, was used to compare IH incidence and associated factors.

Main Results:

• A total of 279 patients were included (MP: 158, SP: 121).
• IH developed in 12 patients (MP: 7 (4.4%), SP: 5 (4.1%)), with comparable rates between groups.
• Previous abdominal surgery and higher BMI were significant risk factors for IH in the MP group, but not consistently in the SP group. MP IH patients had larger tumors than SP IH patients.

Conclusions:

• Incisional hernia rates are comparable between SP and MP RAPN.
• Established risk factors for IH appear to have a stronger impact in the MP RAPN approach.
• SP RAPN may offer a lower observed incidence of IH in specific patient subgroups, particularly with a retroperitoneal approach.