Port Approach Research Articles

Extraperitoneal Single Port vs Transperitoneal Multiport Robot Assisted Radical Prostatectomy in Frail Patients: A Propensity Score Matched Comparative Analysis

PurposeThe rise of frail patients in the worldwide population poses a challenge in the prostate cancer surgical care. In this light, we aimed to compare perioperative and early surgical outcomes of Extraperitoneal Single Port (SP)- vs Transperitoneal Multiport (MP) - Robot Assisted Radical Prostatectomy (RALP) in different frailty settings. Materials and methodsClinical and surgical data of all consecutive patients treated with RALP between March 2014 and October 2023 were gathered. Propensity score matching was performed to adjust for potential baseline pre-operative confounders. The 5-miFI score was calculated for each patient and then three risk categories were identified (5-mFI score = 0, 1 and >2). ResultsA total of 549 patients were assessed in the unmatched analysis. After the propensity score, 126 patients for each treatment group were matched. When stratified in different frailty-groups, 30-days postoperative complications occurred significantly more frequently in case of 5-mFI score >2 (p=0.001). Moreover, higher rate of both overall (52 vs 23%, p=0.01) and major (19.6 vs 8.2%, p=0.02) postoperative complications was found in these patients in case of transperitoneal MP RARP as compared to the extraperitoneal SP procedures. Exploring predictors of postoperative early complications in patients with 5-mFI score >2, extraperitoneal SP robotic approach showed a significant protective role on both overall (OR 0.21, p=0.001) and major (OR 0.33, p=0.001) complications occurrence. ConclusionsIn a matched cohort of patients treated with Robot Assisted Radical Prostatectomy, extraperitoneal Single Port approach significantly reduced the overall and major early complications rate in frail patients.

Modeling and analysis of a flexible spinning Euler-Bernoulli beam with centrifugal stiffening and softening: A linear fractional representation approach with application to spinning spacecraft

The derivation of a linear fractional representation (LFR) model for a flexible, spinning and uniform Euler-Bernoulli beam is accomplished using the Lagrange technique, fully capturing the centrifugal force generated by the spinning motion and accounting for its dependence on the angular velocity. This six degrees of freedom (DOF) model accounts for the behavior of deflection in the moving body frame, encompassing the bending, traction and torsion dynamics. The model is also designed to be compliant with the Two-Input-Two-Output Port (TITOP) approach, which offers the possibility to model complex multibody mechanical systems, while keeping the uncertain nature of the plant and condensing all the possible mechanical configurations in a single LFR. To evaluate the effectiveness of the model, various scenarios are considered and their results are tabulated. These scenarios include uniform beams with fixed root boundary conditions for different values of tip mass, root offset and angular velocity. The results from the analysis of the uniform cantilever beam are compared with solutions found in the literature and obtained from a commercial finite element software. Ultimately, this paper presents a multibody model for a spinning spacecraft mission scenario. A comprehensive analysis of the system dynamics is conducted, providing insights into the behavior of the spacecraft under spinning conditions.

Unveiling nuances in data analysis to illuminate marine pilot strain.

Maritime studies, encompassing a range of disciplines, increasingly rely on advanced data analytics, particularly in the context of navigation. As technology advances, the statistical averaging of large datasets has become a critical component of these analyses. However, recent studies have highlighted discrepancies between statistical predictions and observable realities, especially in high-stress environments like port approach procedures conducted by marine pilots. This study analyzed physiological responses recorded during simulation exercises involving experienced marine pilots. The focus was not on the specific outcomes of the simulations but on the potential faults arising from conventional statistical signal processing, particularly mean-centered approaches. A large dataset of signals was generated, including one signal with a dominant characteristic intentionally designed to introduce imbalance, mimicking the uneven distribution of real-world data. Initial analysis suggested that the average physiological response of the pilots followed an S-shaped curve, indicative of a psycho-physiological reaction to stress. However, further post hoc analysis revealed that this pattern was primarily influenced by a single participant's data. This finding raises concerns about the generalizability of the S-curve as a typical stress response in maritime pilots. The results underscore the limitations of relying solely on conventional statistical methods, such as mean-centered approaches, in interpreting complex datasets. The study calls into question the validity of standardizing data interpretations based on dominant characteristic curves, particularly in environments as intricate as maritime navigation. The research highlights the need for a re-evaluation of these methods to ensure more reliable and nuanced conclusions in maritime studies. This study contributes to the ongoing discourse on data interpretation in maritime research, emphasizing the critical need to re-assess conventional statistical signal processing techniques. By recognizing the potential pitfalls in data generalization, the study advocates for more robust analytical approaches to better capture the complexities of real-world maritime challenges.

Sympathectomy in the treatment of hyperhidrosis: Is it an effective solution?

Background: Primary hyperhidrosis affects 1-3% of the general population and occurs equally in both genders. It significantly affects the quality of life. In recent years, endoscopic thoracic sympathectomy (ETS), especially with a single-port approach, has gained popularity in the treatment of primary hyperhidrosis. This study aims to assess the efficacy and clinical outcomes of ETS surgery for primary hyperhidrosis. Materials and Methods: The data of 30 patients who underwent bilateral ETS due to primary hyperhidrosis were examined retrospectively. 25 patients treated with a single port approach were included in the study, and 5 patients treated with a double port approach were excluded from the study. Preoperative evaluations and routine tests were performed. Patients were evaluated in terms of age, gender, complications, satisfaction, compensatory sweating, and relapse. Patients' satisfaction levels were determined by telephone interviews. Results: The mean patient age was 24.16 ± 6.01 years; 56% were men and 44% were women. As complications, compensatory hyperhidrosis was observed in 12% of the patients, and mild pneumothorax was observed in 12%. No operative mortality occurred. No recurrence was observed during the long-term follow-up. In telephone surveys, 88% of patients reported satisfaction. Three patients with compensatory sweating were partially satisfied. No patient reported regret. Conclusions: We believe that ETS is an effective option in the treatment of primary hyperhidrosis, with low morbidity and high patient satisfaction rates, despite the risk of compensatory sweating.

Ship trajectory prediction using encoder–decoder-based deep learning models

ABSTRACT Accurate prediction of ship trajectories can be an important capability for various maritime transport applications, such as vessel traffic services (VTS), traffic flow assessment, and collision avoidance systems. The widespread availability of AIS (Automatic Identification System) data and the progress made in the deep learning methods in the last decade motivate us to attack this problem from a data-driven perspective. This paper presents the results of a study where various encoder–decoder architectures were applied to the ship trajectory prediction problem using AIS data that were collected from the Rotterdam port approach area. The models were trained with the AIS data along four routes belonging to different ship types/lengths without any clustering or filtering. An average position RMSE of 1.6 km was obtained when the best-performing model predicts ship positions 30 min into the future using 60 min of historical data.

Vats lobectomy for lung cancer. What has been the evolution over the time?

Video assisted thoracic surgery (VATS) lobectomy is the treatment of choice for early-stage lung cancer. It is safe and effective compared to open surgery, as demonstrated by a large body of scientific evidence over the last few decades. VATS lobectomy's evolution was driven by the need to decrease post-operative pain by reducing the extent of surgical accesses, maintaining the same oncological efficacy of open lobectomy with less invasiveness. VATS lobectomy just turned 30 years old, evolving and changing significantly from its origins. The aim of this mini review is to retrace the history, starting from a multiport approach to a single port approach. At the end of this mini review, we will discuss the advanced and the future challenges of the technique that has revolutionized thoracic surgery.

Simple Port Approach to Laparoscopic Repair in Continuous Ambulatory Peritoneal Dialysis

Simple Port Approach to Laparoscopic Repair in Continuous Ambulatory Peritoneal Dialysis

Multi-Ported GC-eDRAM Bitcell with Dynamic Port Configuration and Refresh Mechanism

Embedded memories occupy an increasingly dominant part of the area and power budgets of modern systems-on-chips (SoCs). Multi-ported embedded memories, commonly used by media SoCs and graphical processing units, occupy even more area and consume higher power due to larger memory bitcells. Gain-cell eDRAM is a high-density alternative for multi-ported operation with a small silicon footprint. However, conventional gain-cell memories have limited data availability, as they require periodic refresh operations to maintain their data. In this paper, we propose a novel multi-ported gain-cell design, which provides up-to N read ports and M independent write ports (NRMW). In addition, the proposed design features a configurable mode of operation, supporting a hidden refresh mechanism for improved memory availability, as well as a novel opportunistic refresh port approach. An 8kbit memory macro was implemented using a four-transistor bitcell with four ports (2R2W) in a 28 nm FD-SOI technology, offering up-to a 3× reduction in bitcell area compared to other dual-ported SRAM memory options, while also providing 100% memory availability, as opposed to conventional dynamic memories, which are hindered by limited availability.

Aqueous Humor Circulation in the Era of Minimally Invasive Surgery for Glaucoma.

Glaucoma surgery with implantation of aqueous humor draining microstents may compromise long-term corneal health by disrupting aqueous humor circulation. The effect of stent numbers on this circulation was interrogated to determine the number of stents associated with minimal circulation disruption. An in vitro anterior eye model perfusion system was constructed with multiple exit ports. A 3-D model of the anterior eye was imported into ABAQUS CFD, analyzes were carried out for unsteady laminar flow and solved using Navier-Stokes equations. DT Vision Foundry was used to analyze velocity contour plot images. The field variable results output for the CFD model were fluid wall shear, fluid pressure and fluid velocity. In vitro, "aqueous" fluid flow is high through a single stent and "aqueous" stagnation is greatest in the quadrants 180° away. Increasing stent port numbers, results in an exponential decrease in the stagnant flow locations. High wall shear stress was seen in the single stent model and is markedly reduced after a second and subsequent stents are introduced. We identify two factors potentially contributing to corneal compromise post glaucoma drainage surgery: aqueous humor stagnation, remote to the stent site and higher exit flows imparting increased stent exit shear stress (particularly with a single stent). With 4 stents, there is minimal disruption of anterior chamber circulation (mimicking physiological conditions). Furthermore we propose that aqueous humor circulation disruption via the usual single-exit port approach disrupts aqueous humor circulation with long-term consequences for corneal health.

Evaluation of Triple-Frequency GPS/Galileo/Beidou Kinematic Precise Point Positioning Using Real-Time CNES Products for Maritime Applications

Abstract Our research aims to evaluate the triple-frequency GPS/Galileo/BeiDou kinematic precise point positioning (PPP) accuracy for the international maritime organization (IMO) positioning accuracy and integrity requirements. The real-time Centre National d’Etudes Spatiales (CNES) satellite orbit and clock products are used to simulate real-time scenarios. GPS/Galileo/BeiDou observations are collected from a moving vessel. Both dual-frequency and triple-frequency ionosphere-free PPP models are developed. Different satellite system combinations are used, including GPS-only, GPS/Galileo, GPS/BeiDou, and GPS/Galileo/BeiDou. The GPS-only differential solution is used as a reference. It is found that both dual- and triple-frequency kinematic PPP solutions achieve the IMO accuracy requirements at 95% confidence level for ocean, coastal, port approach, port, inland waterways, and track control navigation applications, except the automatic docking application. Moreover, the PPP solutions fulfilled the IMO integrity requirements for all navigation phase applications, but the GPS and GPS/BeiDou PPP solutions did not fulfill the automatic docking integrity requirement.

Demonstration of the Feasibility of the Korean eLoran System as a Resilient PNT in a Testbed

With the increasing utilization of location information, attempts to improve the safety of absolute positioning coordinates, which have depended on global navigation satellite systems (GNSSs), such as the Global Positioning System (GPS), are underway. Among these, enhanced long range navigation (eLoran) is the most technically developed system. In Korea, related technologies have been developed since 2016, and a testbed for eLoran performance evaluation, which is currently in operation as a pilot service, was completed in 2021. We analyze the position accuracy of the eLoran pilot service to use it as an alternative when GNSS usage is challenging within Korea’s eLoran testbed. We evaluated the accuracy of the absolute position using the eLoran system by sailing up to 160 km away from the Incheon testbed transmitter according to four navigation stages (inland waterway, port approach, coastal, and ocean) classified by the International Maritime Organization (IMO). To validate the eLoran positioning performance in which an additional secondary factor (ASF) map is not provided, we propose a differential GPS (DGPS) position-based ASF estimation technique. Based on this study, Korea’s eLoran system can calculate the absolute position with an accuracy of approximately 15 m with 95% probability at the port-approach stage.

Port Site Infections after Elective Laparoscopic Cholecystectomy at a Tertiary Care Centre of Jharkhand: A Prospective Observational Study

Introduction: Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gallstone disease. However post-operative complications of elective laparoscopic cholecystectomy could not be ignored. Port site infection is one of the most common complications after laparoscopic surgeries. Materials and Methods: 251 Patients of both sexes with age group 23 to 65 years having symptomatic gall stone disease were studied. A prospective observational study was performed in the Department of General Surgery of Tata Main Hospital in collaboration with Manipal Tata Medical College, Jamshedpur, Jharkhand. The study was conducted from September 2022 to April 2023. Ethical clearance was obtained from the Institutional Ethics Committee and all relevant data were retrieved from hospital records. Routinely all the patients were given prophylactic broad spectrum antibiotics Ceftriaxone 1g stat by intravenous infusion at the of induction of an anaesthesia. Post-operatively all patient received ceftriaxone 1gm twice daily for 24. Metronidazole 500 mg added thrice daily intravenous infusion for 72 hours in case of spillage of bile or stone or pus and those with acute cholecystitis. All data were collected in preformed format and statistical analysis was done. Results: The mean age of studied patients group ranging from 23 to 65 years are 41.6 years. Majority (220/251, 87.64%) of the patients were female. Majority of the patients were in the BMI range of 18.5-40kg/m2 (47%). Spillage of bile and gall Stones, umbilical port approach, high BMI and surgery in acute phase are associated with high incidence of port site infection; such incidence of biliary spillage was reported with 20(7.96%) cases. Port Site Infection (PSI) was occurred in 13 patients (11 females and 2 males), which constituted 5.17% of the study population. Out of these cases, 1(7.6%) case was deep seated and rests 2 were superficial infection. Conclusion: Special consideration should be taken in chronic deep surgical site. Infection like port site persistent sinus. Most of the PSIs are superficial which got cured with regular dressing and more common in females.

An evaluation of the governance structure of marine services in South Africa’s ports system

Port governance structures are a vital factor impacting port investments, efficiencies, effectiveness and productivity. An important determining factor is the port management and whether it is centralized under the national government as a State-Owned Enterprise (SOE), decentralized to the municipal level, or alternatively privatized. Reforms in port management indicate that ports either subscribe to a public service port, tool port, landlord port or private port approach. Several inefficiencies exist in the governance, pricing and performance of marine services in South Africa. This study aims to evaluate the governance structure of marine services in South Africa’s ports. The research methodology included observations, a focus group with six participants and semi-structured interviews with twenty participants that included port managers, harbour masters, port experts, port agents, terminal operators, and cargo owners. The main findings confirmed the need for the participation of private service providers in the provision of marine services in South Africa’s ports and additional regulations on marine services to advance investment, performance and protection of port users. Although there is a need for private sector participation in the provision of marine services in South Africa’s ports, participation should enhance the country’s economic and developmental agenda, including job creation, investment in infrastructure, improved service provision and transforming the ports system.

A Multi-Institutional Experience Utilizing Boari Flap in Robotic Urinary Reconstruction.

Objectives: There is presently scarce literature describing the outcomes of patients undergoing robotic ureteral reconstruction (RUR) using the Boari flap (BF) technique. Herein, we report our prospective, multi-institutional experience using BF in patients undergoing robotic urinary reconstruction. Patients and Methods: We reviewed our prospective, multicenter database for all patients undergoing RUR between September 2013 and September 2021 in which a BF was utilized. Preoperative, perioperative, and follow-up data were collected and analyzed. Major complications were defined as a Clavien-Dindo classification grade >2. Surgical failure was defined as recurrent symptoms, obstruction on imaging, or the need for additional surgical interventions. Results: We identified 50 patients who underwent RUR using a BF. Four (8%) underwent the Single Port approach. Twenty-four patients (48%) were active or former tobacco users. Thirty-four patients (68%) had previously undergone abdominal surgery, 17 (34%) had prior ureteral stricture interventions, and 9 (18%) had prior abdominopelvic radiation. The most common stricture etiology was malignancy (34.4%). The median follow-up was 15.0 months with a 90% (45/50) success rate. The five documented cases of failure occurred at a median of 1.8 months following the procedure. Conclusion: In the largest prospective, multi-institutional study of patients undergoing RUR with BF in the literature to date, we demonstrate a low rate of complications and a high rate of surgical success in three tertiary academic medical centers. All observed failures occurred within 2 months of surgical intervention.

Incarerated femoral hernia in women – A critical view on approach options

Introduction and importanceIn the literature there is few information on femoral hernias while best surgical approach to groin hernia in women is in recent discussion ([1], [2]). Focused on femoral hernia our purpose is to present a possible pathway for incarcerated female hernia approach demonstrated on four cases. Case presentationFour female patients (77–90 y) with suspected incarcerated inguinal unilateral hernia undergoing repair at our department between December 2017 and December 2018 are presented. In three patients emergency laparoscopy by single port approach confirmed incarceration. Bowel was reduced and femoral hernia diagnosed. A TAPP repair was performed. The fourth patient had multiple previous abdominal operations due to anal carcinoma, so laparoscopic approach was not recommended. A transinguinal open approach also showed an incarcerated femoral hernia. Clinical discussionIn case of suspected incarcerated inguinal hernia accurate identification of a femoral hernia is necessary especially in female elderly patients. If possible endoscopic approach is preferred and offers exploration of both sides, checking bowel for vitality and fixing the hernia. If bilateral hernia is present, both sides should be addressed. Surgeons not used to TAPP should perform diagnostic laparoscopy with reduction of hernia sac and check of content and switch to TEP if experienced or open procedure. If open approach is necessary checking for femoral hernia is also mandatory and preperitoneal mesh placement is recommended with or without ligation of inferior epigastric vessels. ConclusionFemoral hernias in women are not rare and in open repair techniques easily overseen. The endoscopic approach is preferred. With open approach the exploration via transversalis fascia is mandatory.

V09-11 ROBOT-ASSISTED LAPAROSCOPIC PYELOLITHOTOMY AND SIDE-TO-SIDE PYELOPYELOSTOMY

You have accessJournal of UrologyCME1 Apr 2023V09-11 ROBOT-ASSISTED LAPAROSCOPIC PYELOLITHOTOMY AND SIDE-TO-SIDE PYELOPYELOSTOMY Mario Basulto-Martínez, Eduardo González-Cuenca, and Stephen Pautler Mario Basulto-MartínezMario Basulto-Martínez More articles by this author , Eduardo González-CuencaEduardo González-Cuenca More articles by this author , and Stephen PautlerStephen Pautler More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003317.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Duplication of the collecting system is the most common congenital ureteral abnormality. We aimed to describe a robot-assisted laparoscopic pyelolithotomy and a side-to-side pyelopyelosotmy in a patient with a duplex system and a stricture. METHODS: A 55 years-old man was referred to our center for right flank pain and proximal stones in the context of an incomplete duplex system. The endourology team tried a retrograde and antegrade approach and were both unsuccessful due to an unpassable stricture distal to the stone. Baseline imaging found an obstructed upper moiety with a cluster of stones in its ureter following by and obstructive stricture, and a renogram showed a split function of 39%. A standard 5 port approach was performed, and both ureters were identified. The, the ureter draining the upper moiety was incised and the stones were extracted. The stricture was identified and excised. The pelvis and ureter draining the lower moiety were also incised longitudinally and the posterior aspect of both ureters was sutured. A stent was advanced, and the anterior aspect of both ureters was closed. RESULTS: The estimated blood loss was 100 mL and the patient was discharged the next day. The stent was removed 4 weeks after and the patients is currently pain-free. A follow up imaging showed resolution of the upper moiety hydronephrosis and excretion of contrast in both ureters through the pyelopyelostomy. CONCLUSIONS: A side-to-side pyelopyelostomy is a feasible and safe technique in patients with a a duplex system and obstruction. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e840 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mario Basulto-Martínez More articles by this author Eduardo González-Cuenca More articles by this author Stephen Pautler More articles by this author Expand All Advertisement PDF downloadLoading ...

Optimising ship manoeuvring time during port approach using a decision support system: a case study in Turkey

ABSTRACT Any cost reductive initiative is significant to contribute to the overall viability and economic sustainability of the industry. Therefore, it is worthy to study time and cost efficiency of ship manoeuvring when approaching the port. This study develops a decision support system model by utilising a goal programming integrated ship manoeuvring methodology, which examines ship and environmental variables concerning manoeuvring. A case study was then carried out using 2 different container ships approaching Gemport berths in Turkey, to show the practical applicability of the methodology. The results of the case study showed that it would be possible to reduce manoeuvring time in approaching the port from 31.6 min to 27.36 min in ship I and from 59 min to 48.05 min in ship II. These results are significant as they can provide cost efficiency for ship owners and port authorities, especially when we consider its applicability for the entire world merchant marine fleet.

Advances in fine line-of-sight control for large space flexible structures

The increased need in pointing performance for Earth observation and science Space missions together with the use of lighter and flexible structures directly come with the need of a robust pointing performance budget from the very beginning of the mission design. An extensive understanding of the system physics and its uncertainties is then necessary in order to push control design to the limits of performance and constrains the choice of the set of sensors and actuators. A multi-body framework, the Two Input Two Output Ports approach, is used to build all the elementary flexible bodies and mechanisms involved in a fine pointing mission. This framework allows the authors to easily include all system dynamics with an analytical dependency on varying and uncertain mechanical parameters in a unique Linear Fractional Transformation (LFT) model. This approach opens the doors to modern robust control techniques that robustly guarantee the expected fine pointing requirements. In particular, a novel control architecture is proposed to reduce the microvibrations induced both by reaction wheel imbalances and Solar Array Drive Mechanism driving signal, by letting them work during the imaging phase. Thanks to a set of accelerometers placed at the isolated base of the payload and in correspondence of the mirrors with the largest size in a Space telescope (typically the primary and secondary ones), it is possible to estimate the line-of-sight error at the payload level by hybridizing them with the low-frequency measurements of the camera. While a classical Fast Steering Mirror in front of the camera can compensate for a large amount of microvibration, an innovative architecture with a set of six Proof-Mass Actuators installed at the payload isolator level can further improve the pointing performance. In particular, it is shown how the proposed architecture is able to robustly guarantee an absolute performance error of 10 arcsec in face of system parametric uncertainties at low frequency (≈ 1rad/s) with a progressive reduction of the jitter down to 40 marcsec for higher frequencies where micro-vibration sources act.

Selection of minimally invasive surgical approaches for treating esophageal cancer.

Minimally invasive esophagectomy has gradually been accepted as an active treatment option for surgery of esophageal cancer. However, there is no consensus about how to perform the procedures in the thoracic and abdominal phase including anastomosis in the neck (McKeown) or chest (Ivor Lewis), VATS, robotic‐assisted or reduced port approaches or various endoscopic abrasion techniques. Further studies to investigate the roles of these novel techniques are required to treat the various patient populations.

V13-12 SINGLE PORT DA VINCI ROBOTIC RADICAL ADRENALECTOMY VIA MCBURNEY INCISION

You have accessJournal of UrologyCME1 May 2022V13-12 SINGLE PORT DA VINCI ROBOTIC RADICAL ADRENALECTOMY VIA MCBURNEY INCISION Jason Elyaguov, Mubashir Billah, Michael Stifelman, and Mutahar Ahmed Jason ElyaguovJason Elyaguov More articles by this author , Mubashir BillahMubashir Billah 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.0000000000002646.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Incidental adrenal masses are often benign and biopsy is not recommended. However, malignant potential exists in 6% of lesions >4cm and as high as 25% in lesions over 6cm, as a result surgical resection is recommended for masses over 5cm. Robotic resection today is considered standard of care, and the single port approach is novel and minimally described. In this video, we aim to review da Vinci single port (SP) access for left adrenalectomy via a McBurney incision as well as describe robotic instrument and assistant port configuration via the specialized da Vinci SP globe and demonstrate surgical technique for efficient and safe adrenal gland excision. METHODS: 59 year old male initially presented with left flank pain and CT imaging showed large left renal cysts as well as an incidental heterogenous 4.8 cm x 3.9 cm left adrenal mass with mixed attenuation. Full metabolic workup was normal. Surveillance MRI showed the mass to be >5cm and therefore patient elected for surgical resection. He underwent an SP left adrenalectomy in the right lateral decubitus position via a McBurney incision employing the specialized multi-access SP globe port, allowing for optimal dissection. We highlight efficient and judicious use of bipolar cautery in ligating the adrenal vein and excising out the adrenal gland. RESULTS: The patient tolerated the procedure well with a total operative time of 78 minutes and minimal blood loss. No intra-abdominal drain was placed, while a Foley catheter was removed 12 hours post operatively. The patient was discharged within 24 hours with no residual symptoms or complications at 90-day follow-up. The small single incision healed very well. Final pathology favored adrenal adenoma with a 4.2cm tumor and positive-free margins. CONCLUSIONS: SP da Vinci robotic adrenalectomy with multi-access globe port is feasible and safe. The McBurney incision allows for efficient access to the renal hilum and avoids risk of midline hernia, while providing excellent cosmesis and minimal pain. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1034 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jason Elyaguov More articles by this author Mubashir Billah More articles by this author Michael Stifelman More articles by this author Mutahar Ahmed More articles by this author Expand All Advertisement PDF DownloadLoading ...