Comparison of outcomes between single-port and multi-port robotic radical nephrectomy

J Robot Surg. 2024 Nov 15;18(1):407. doi: 10.1007/s11701-024-02127-x.

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 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.

Keywords: Multi port; Peri-operative outcomes; Radical nephrectomy; Robotic; Single port.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Loss, Surgical / statistics & numerical data
  • Female
  • Humans
  • Kidney Neoplasms* / surgery
  • Length of Stay* / statistics & numerical data
  • Male
  • Middle Aged
  • Nephrectomy* / methods
  • Operative Time*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Treatment Outcome