Mp26-14 single port robotic assisted versus laparoscopic radical and partial nephrectomy: single surgeon comparison

You have accessJournal of UrologyCME1 Apr 2023MP26-14 SINGLE PORT ROBOTIC ASSISTED VERSUS LAPAROSCOPIC RADICAL AND PARTIAL NEPHRECTOMY: SINGLE SURGEON COMPARISON Alexa Meyer, Aaron Zhang, Adam Hass, Stephanie Banks, Ella Taubenfeld, Jared Winoker, Ridwan Alam, Lee Richstone, and Louis Kavoussi Alexa MeyerAlexa Meyer More articles by this author , Aaron ZhangAaron Zhang More articles by this author , Adam HassAdam Hass More articles by this author , Stephanie BanksStephanie Banks More articles by this author , Ella TaubenfeldElla Taubenfeld More articles by this author , Jared WinokerJared Winoker More articles by this author , Ridwan AlamRidwan Alam More articles by this author , Lee RichstoneLee Richstone More articles by this author , and Louis KavoussiLouis Kavoussi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003254.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite the availability of the da Vinci Single Port (SP) system, wide adoption and report of its use for single site surgery remain limited. For radical (RN) and partial nephrectomy (PN), few series report on the use of the SP system with minimal comparisons to current standard-of-care minimally invasive treatments. In this series, we describe a single surgeon’s initial experience with the da Vinci SP system for RN and PN and compare it to laparoscopic RN and PN performed during this time frame. METHODS: We retrospectively reviewed all patients who underwent RN and PN since the introduction of the SP system within the health system. Patients who underwent SP and laparoscopic surgery were compared based on pre-, peri-, and post-operative outcomes, including baseline demographics, tumor size, estimated blood loss (EBL), operating room (OR) time, length of hospital stay (LOS), and complications. RESULTS: Between March 8, 2021 and May 2, 2022, a total of 121 patients underwent PN or RN by a single surgeon (LRK). A total of 78 patients underwent laparoscopic surgery (49 PN and 29 RN) and 43 patients underwent SP surgery (31 PN and 12 RN). Patients were comparable with respect to age, race, and body mass index. Those who underwent laparoscopic surgery had larger tumors (4.0 versus 3.1, p=0.02) and higher ASA scores (p=0.04). There were no significant differences between the two groups in terms of length of surgery (p=0.10), rate of conversion (p=0.62), intraoperative and postoperative complications (p>0.99 and p=0.45, respectively), and length of stay (p=0.45). Patients who underwent SP-PN had significantly longer ischemia time than patients who underwent laparoscopic PN (median 20 minutes versus 0 minutes, p =0.02), and significantly lower EBL (median 200 cc versus 300 cc, p =0.003). The SP group was discharged with significantly less narcotic prescriptions (10 patients versus 59 in laparoscopic group, p <0.001). CONCLUSIONS: The SP system appears to be a safe and feasible approach to performing RN and PN. A potential benefit is lower postoperative narcotic requirements. This may be due to midline port placement for the SP system versus the addition of a lateral port in the traditional laparoscopic approach. Limitations of the study include the retrospective nature and inherent selection bias. Further studies are needed to better characterize the relative safety and indications for a SP approach in renal surgery, compared to traditional laparoscopic and open techniques, as well as to thoroughly evaluate both long-term oncological outcomes and potential pain-related advantages. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e358 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexa Meyer More articles by this author Aaron Zhang More articles by this author Adam Hass More articles by this author Stephanie Banks More articles by this author Ella Taubenfeld More articles by this author Jared Winoker More articles by this author Ridwan Alam More articles by this author Lee Richstone More articles by this author Louis Kavoussi More articles by this author Expand All Advertisement PDF downloadLoading ...