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Single-port robotic partial and radical nephrectomies for renal cortical tumors: initial clinical experience

Abstract

To describe our institution’s initial experience with radical (RN) and partial nephrectomy (PN) using the SP robotic system. The recent FDA approval of the da Vinci® SP robotic platform has led to its use in minimally invasive approaches to urologic malignancies. There are little data on its feasibility and safety after implementation for radical and partial nephrectomy. All patients who underwent PN or RN using the SP system at our institution were reviewed. All PNs were performed off-clamp. Patient demographics, preoperative imaging, operative approaches, and perioperative outcomes were collected and analyzed. Sixteen patients underwent PN (n = 13) or RN (n = 3) utilizing the SP robotic system between January 2019 and June 2019. Average age was 58.6 ± 13.9 and 61.0 ± 1.7 years in each group, respectively. A retroperitoneal approach was performed in 7 (53.8%) PN patients and 1 (33.3%) RN patient. A transperitoneal approach was performed in 6 (46.1%) PNs and 2 (66.7%) RNs. Mean operative time and median estimated blood loss for PN was 176.9 ± 64.0 min and 200 (50–800) ml compared to 176.3 ± 73.8 min and 50 (50–400) ml for RN. There was one operative conversion (7.7%) to an open approach in the PN group. Length of hospital stay postoperatively averaged 1.9 ± 1.3 days and 3.3 ± 1.2 days for patients undergoing partial and radical nephrectomy, respectively. SP partial and radical nephrectomies through transperitoneal and retroperitoneal approaches appear to be feasible surgical techniques in the management of cortical renal masses. Off-clamp PN is also a feasible approach using the SP system. However, further study is needed to establish its safety and use in renal surgery across multiple institutions and larger patient cohorts.

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Funding

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Author information

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were formed by Andrew M. Fang, Ava Saidian, Cristina Magi-Galluzzi, Jeffrey W. Nix, and Soroush Rais-Bahrami. The first draft of the manuscript was written by Andrew M. Fang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Correspondence to Soroush Rais-Bahrami.

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Conflict of interest

Jeffrey W. Nix, M.D. serves as a consultant for Philips/InVivo Corp and Intuitive Surgical. Soroush Rais-Bahrami, M.D. serves as a consultant for Philips/InVivo Corp, Intuitive Surgical, Genomic Health Inc, Bayer Healthcare, and Blue Earth Diagnostics.

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All procedures performed in studies involving human participants were approved by the University of Alabama at Birmingham Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Fang, A.M., Saidian, A., Magi-Galluzzi, C. et al. Single-port robotic partial and radical nephrectomies for renal cortical tumors: initial clinical experience. J Robotic Surg (2020). https://doi.org/10.1007/s11701-020-01053-y

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Keywords

  • Kidney cancer
  • Renal surgery
  • Robotics
  • Nephrectomy
  • Partial nephrectomy