Comparison of Outcomes Between Single-port and Multi-port Robotic Radical Nephrectomy

Overview

Journal J Robot Surg

Publisher Springer

Specialties Biotechnology
General Surgery

Date 2024 Nov 15

PMID 39546130

Authors

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

Affiliations

Soon will be listed here.

Abstract

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 χ, 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.

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