V02-06 PRACTICAL TIPS AND TRICKS FOR SUCCESSFUL SINGLE PORT ROBOTIC PARTIAL NEPHRECTOMY

Abstract

INTRODUCTION AND OBJECTIVE: The Intuitive Surgical DaVinci SP (“Single Port”) robotic platform was initially approved in 2014, and in the last year, there has been dissemination of the technology. Multiple urological procedures have been successfully adapted to the SP robot, however there are some important differences from prior models. We aimed to share some practical tips and tricks for successful single port robotic assisted partial nephrectomy (SP-RAPN). METHODS: We performed a retrospective review of our initial SP-RAPN case series between 5/2019 and 9/2019. We extracted patient characteristics and early surgical outcomes. Surgical tips and tricks were recorded during these cases and assembled in a video. RESULTS: SP-RAPN was successfully completed in 7 patients. Patients mean age was 58.9 ± 13.4 years and median ASA score was 2. Mean tumor size 3.6 ± 2.6 cm. The average OR Time was 197 ± 34 minutes and EBL was 82 ± 100 mL. All cases had warm ischemia time <25 minutes. Tumor Pathology included 4 RCC (2 pT1a, 1 pT1b, 1 pT2a), 2 AML, and 1 oncocytoma. There were no transfusions, intraoperative complications or readmission. Our top surgical tips involved: 1) patient positioning, 2) port placement, 3) insufflation, 4) air docking, 5) assistant port placement, 6) dynamic arm control, 7) hilar clamping, 8) camera relocation, 9) tumor excision, and 10) extraction and port closure. CONCLUSIONS: SP-RAPN is safe and feasible in our early series. There are advantages to this platform like excellent cosmetic results, but there are also several disadvantages. As the technology matures and techniques evolve, the SP-RAPN may become more appealing. Future studies should focus on long-term outcomes and cost effectiveness of this platform. Source of Funding: None