MP10-06 SINGLE- VERSUS MULTI-PORT ROBOTIC PARTIAL NEPHRECTOMY: A COMPARATIVE ANALYSIS OF PERIOPERATIVE OUTCOMES AND ANALGESIC REQUIREMENTS

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-06 SINGLE- VERSUS MULTI-PORT ROBOTIC PARTIAL NEPHRECTOMY: A COMPARATIVE ANALYSIS OF PERIOPERATIVE OUTCOMES AND ANALGESIC REQUIREMENTS Zachary Glaser, Zachary Burns, Andrew Fang, Ava Saidian, Christina Magi-Galluzzi, Jeffrey Nix, and Soroush Rais-Bahrami Zachary GlaserZachary Glaser More articles by this author , Zachary BurnsZachary Burns More articles by this author , Andrew FangAndrew Fang More articles by this author , Ava SaidianAva Saidian More articles by this author , Christina Magi-GalluzziChristina Magi-Galluzzi More articles by this author , Jeffrey NixJeffrey Nix More articles by this author , and Soroush Rais-BahramiSoroush Rais-Bahrami More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The da Vinci single-port (SP) robotic platorm permits true single-incision surgery through a 2.5 cm multi-channel trocar. While several series have demonstrated safety and oncologic efficacy for radical prostatectomy, evidence supporting the safe use of the SP platform for partial nephrectomy is scarce. The purpose of this study was to evaluate safety and postoperative opioid analgesic requirements for patients undergoing robotic assisted (RAL) SP vs multi-port (MP) partial nephrectomy (PNx) in a time-matched cohort. METHODS: All patients with clinically-localized renal masses who underwent RAL PNx from January 2019 to March 2020 were evaluated. Patients were stratified according to SP vs MP approach. Renal mass complexity was compared using R.E.N.A.L. nephrometry scores on preoperative cross-sectional imaging. Trans- vs. retroperitoneal approach, operative time, use of a separate assistant port for SP cases and estimated blood loss (EBL) were among the intraoperative data tracked. Postoperative analgesia was administered in accordance with department-wide opioid stewardship protocol and outpatient opioid use was tracked using the Alabama Prescription Drug Monitoring Program. RESULTS: A total of 78 patients underwent RAL PNx with 26 patients in the SP cohort. The majority of renal masses had low-complexity (53, 67.9%) R.E.N.A.L. nephrometry scores, without a significant difference between the two cohorts (p=0.19). A retroperitoneal approach was performed in 16 (20.5%) patients overall, though more commonly via the SP robotic approach (13 vs 3, p<0.001). Mean operative time for SP cases was 183.9 min vs 208.6 min in the MP cohort (p=0.12). A separate assistant port was utilized during 16 (61.5%) SP cases.Rate of conversion to radical nephrectomy was 3.8% vs 9.6% for SP vs MP cases, respectively, (p=0.37). Significant EBL defined as greater than 500cc did no significantly differ in the two cohorts (p=0.11). The majority of patients were discharged on postoperative day one (67.9%) irrespective of operative approach (p=0.60). There were no differences in inpatient milligram morphine equivalents administered (MME, p=0.08) or outpatient postoperative MME prescribed (p=0.21) between the two cohorts. CONCLUSIONS: In this retrospective single-institution study, SP robotic approach offers similar short-term perioperative outcomes to MP platforms for minimally-invasive, nephron-sparing surgery. Using the SP system was not associated with a reduction in postoperative opioid analgesic requirements. Source of Funding: Not applicable © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e170-e170 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary Glaser More articles by this author Zachary Burns More articles by this author Andrew Fang More articles by this author Ava Saidian More articles by this author Christina Magi-Galluzzi More articles by this author Jeffrey Nix More articles by this author Soroush Rais-Bahrami More articles by this author Expand All Advertisement Loading ...