V08-06 BILATERAL PYELOPLASTY WITH SINGLE PORT ROBOT - ONE INCISION, ONE POSITION

Abstract

You have accessJournal of UrologyNOTES/LESS (V08)1 Sep 2021V08-06 BILATERAL PYELOPLASTY WITH SINGLE PORT ROBOT - ONE INCISION, ONE POSITION John Sheng, Chrystal Chang, Gregory Lovallo, Michael Stifelman, and Mutahar Ahmed John ShengJohn Sheng More articles by this author , Chrystal ChangChrystal Chang More articles by this author , Gregory LovalloGregory Lovallo More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , and Mutahar AhmedMutahar Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002041.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Da Vinci Single Port (SP) robotic system has made it feasible to perform robotic surgery through one incision. This technology advances minimally invasive surgery, allowing for multiple instruments through a single 25mm port. -In this video, we demonstrate the feasibility of performing bilateral retroperitoneal surgery through a single small Pfannenstiel incision. -We previously showed this surgery with an assistant port. Now we demonstrate the use of the remotely operated suction irrigation (ROSI) system in making this a true single port surgery. METHODS: A 26 year old female with bilateral symptomatic UPJ obstructions and multiple large left kidney stones presented for robotic assisted bilateral pyeloplasty and left pyelolithotomy. Whereas using a multiport approach may have necessitated more than 5 incisions to perform bilateral surgery, we demonstrate using one incision and re-docking the single port robot to perform bilateral pyeloplasty. We did not need to re-drape the patient in order to perform the second side. RESULTS: Our patient tolerated the procedure well with excellent cosmetic and functional outcomes. Foley catheter was removed 12 hours post op. Drain had minimal output and was removed 2 hours after foley removed. Patient was discharged within 18 hours of surgery without any narcotic use post operatively. Stents were removed 4 weeks later and the patient remains asymptomatic. A total of 24 single port pyeloplasties were performed by three surgeons at our institution over an 18 month period. Two, including the one described in this video, were bilateral. Average operative time was 128 minutes. Average estimated blood loss was 20cc. Average length of stay was 1.1 days. CONCLUSIONS: Using Single Port robot has the potential to: Have better cosmesis with only one incision. Have improved pain control. Be able to use lower incision on abdomen to perform kidney surgery by pointing instruments upward. Advance robotic surgery in an even more minimally invasive way. In this video, we are able to demonstrate bilateral retroperitoneal surgery without the use of an assistant port through a single small Pfannenstiel incision. Limitations: SP has a learning curve and is may not be able to translate multiport skills entirely to single port. Cannot use indocyanine green with single port system yet to be able to identify and preserve vascularity of ureter for reconstructive cases. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e602-e602 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Sheng More articles by this author Chrystal Chang More articles by this author Gregory Lovallo More articles by this author Michael Stifelman More articles by this author Mutahar Ahmed More articles by this author Expand All Advertisement Loading ...