MP50-14 SINGLE PORT VS MULTI PORT ROBOTIC RENAL SURGERY: ANALYSIS OF PERIOPERATIVE OUTCOMES FOR EXCISION OF HIGH AND LOW COMPLEXITY RENAL MASSES

Abstract

You have accessJournal of UrologyCME1 May 2022MP50-14 SINGLE PORT VS MULTI PORT ROBOTIC RENAL SURGERY: ANALYSIS OF PERIOPERATIVE OUTCOMES FOR EXCISION OF HIGH AND LOW COMPLEXITY RENAL MASSES Grant Henning, Joel Vetter, Nicholas Pickersgill, Arjun Sivaraman, R. Sherburne Figenshau, and Eric Kim Grant HenningGrant Henning More articles by this author , Joel VetterJoel Vetter More articles by this author , Nicholas PickersgillNicholas Pickersgill More articles by this author , Arjun SivaramanArjun Sivaraman More articles by this author , R. Sherburne FigenshauR. Sherburne Figenshau More articles by this author , and Eric KimEric Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002625.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is limited data on the safety and feasibility of the da Vinci Single Port (SP)® robotic surgical system (Intuitive Surgical, Sunnyvale, CA) as a minimally invasive alternative to robotic platforms requiring multiple ports. We sought to compare perioperative outcomes between SP and multi-port (MP) robotic approaches for excision of high and low complexity renal masses. METHODS: Retrospective chart review was performed for all patients undergoing robotic partial or radical nephrectomy using the SP surgical system (N=23) at our institution between its adoption in November 2019 and November 2021. Patient demographics, preoperative imaging, operative approaches, and perioperative outcomes were recorded. Renal masses were categorized into high (7+) and low complexity groups (4-6) using the RENAL nephrometry scoring system (RNS). Patients were matched using an institutionally maintained MP database by patient BMI, renal mass size, renal mass complexity, and partial or radical nephrectomy in a 2:1 (MP:SP) ratio. Perioperative outcomes were compared. RESULTS: For high complexity tumors (N=12), SP renal surgery was associated with a significantly longer average operative time compared to MP surgery (248.4 ± 75.0 min vs 188.1 ± 61.0 min, p=0.02), and tended towards higher average estimated blood loss (410.0 ± 669.9 mL vs 171.2 ± 136.0 mL, p=0.62) and a higher positive surgical margin rate (25.0% vs 12.5%, p=0.38). For low complexity tumors (N=11), there was no significant difference in operative time (177.7 ± 53.9 min vs 161.4 ± 41.9 min, p=0.53), average estimated blood loss (69.6.0 ± 33.0 mL vs 142.0 ± 168.6 mL, p=0.62) or positive margins (9.1% vs 4.5%, p=1.00) between SP and MP approaches and all patients underwent successful partial nephrectomy using the SP system. Increasing nephrometry score was associated with a greater relative increase in operative time for SP compared to MP renal surgery (p=0.07) using best of fit linear modeling (Figure 1). CONCLUSIONS: SP nephron-sparing surgery is safe and feasible for low complexity renal masses. For excision of high complexity renal masses, the SP system is associated with a significantly longer operative time when compared to a MP approach. Careful selection should be performed when planning operative approach. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e870 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Grant Henning More articles by this author Joel Vetter More articles by this author Nicholas Pickersgill More articles by this author Arjun Sivaraman More articles by this author R. Sherburne Figenshau More articles by this author Eric Kim More articles by this author Expand All Advertisement PDF DownloadLoading ...