Single-port (SP) robotic surgery is a novel technology, and although there is emerging data, it remains limited in assessing single-port (SP) robot-assisted surgery as an alternative to multi-port (MP) platforms. To compare perioperative and postoperative outcomes between SP and MP robotic technologies for radical nephrectomy (RN). This is a retrospective cohort study of patients who have undergone robot-assisted radical nephrectomy using either the SP or MP technology. Baseline demographics, clinical, tumor-specific characteristics, and perioperative and postoperative outcomes were compared using χ2, t-test, Fisher exact test, and Mann-Whitney U test. Multivariable analyses were conducted using robust, Poisson, and logistic regressions. A total of 341 patients underwent robotic RN with 47 patients (14%) in the SP group. The two groups exhibited similar baseline characteristics, with no significant differences in age, sex, body mass index, Charlson comorbidities index, and tumor laterality. However, SP group had a smaller average tumor size (5.1 cm vs 6.4 cm, p = 0.009). The SP had longer operative time (178 ± 84 min vs 142 ± 75 min; p = 0.011) but showed no significant difference in the estimated blood loss, blood transfusion rate, length of stay, overall 30-day and major complication rates. Controlling for other variables, SP was significantly associated with a longer operative time and shorter length of stay. SP is associated with longer operative time but offers advantages such as smaller incisions and shorter hospital stays with a comparative safety profile to MP for radical nephrectomy.
Journal of robotic surgery. 2024 Nov 15*** epublish ***
Kennedy E Okhawere, Shirin Razdan, Jewel Bamby, Indu Saini, Laura Zuluaga, Ruben Calvo Sauer, Nicolas Soputro, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, James Porter, Ronney Abaza, Ahmed Mansour, Mutahar Ahmed, Simone Crivellaro, Phillip M Pierorazio, Nirmish Singla, Jihad Kaouk, Michael D Stifelman, Ketan K Badani
Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 6th Floor, New York City, NY, 10029, USA., Department of Urology, University of Illinois at Chicago, Chicago, IL, USA., Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA., Division of Urology, Mount Sinai Medical Center, Miami Beach, FL, USA., Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA., Department of Urology, Swedish Medical Center, Seattle, WA, USA., Department of Urology, Central Ohio Urology Group, Columbus, OH, USA., Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA., Hackensack University Medical Center, Hackensack, NJ, USA., Section of Urology, Penn Presbyterian Medical Center, Philadelphia, PA, USA., Brady Urological Institute at Johns Hopkins University, Baltimore, MD, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 6th Floor, New York City, NY, 10029, USA. .