Anatomical tour: Single-port retroperitoneal partial nephrectomy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• The single-port (SP) robotic platform is transforming minimally invasive renal surgery.
• The retroperitoneal low anterior access (LAA) approach is a versatile technique gaining favor.
• Current literature lacks detailed guidance on SP retroperitoneal partial nephrectomy.

Purpose of the Study:

• To provide an anatomically grounded account of operative steps for SP retroperitoneal partial nephrectomy.
• To detail decision points unique to this surgical approach.
• To address the growing need for information as SP adoption increases.

Main Methods:

• Review of current literature and surgical techniques.
• Analysis of operative steps and decision-making in SP retroperitoneal partial nephrectomy.
• Examination of the impact of tumor location on surgical approach selection.

Main Results:

• The da Vinci SP platform enables treatment of diverse renal tumor locations via a retroperitoneal approach.
• The SP platform allows access to anterior, posterior, hilar, and polar tumors from a single site.
• This approach simplifies access and broadens applicability compared to traditional multiport surgery.

Conclusions:

• A retroperitoneal-first strategy with the SP platform streamlines surgery and expands its use in nephron-sparing procedures.
• This approach facilitates adoption by trainees and surgeons experienced in transperitoneal techniques.
• Further comparative and long-term outcome data are necessary for optimal patient selection.