Initial Experience With Single-Port Robotic Partial Nephrectomy in MUSIC-KIDNEY

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: Robotic partial nephrectomy (RPN) has become standard of care for patients with T1 renal masses (T1RMs) amenable to nephron-sparing intervention. Most RPNs use the daVinci Xi (multiport) robot, and urologic surgeons have recently explored the SP (single port) robot. However, there is limited data comparing patient selection and peri-operative outcomes for SP to Xi RPN. We evaluated the outcomes of the initial series of patients undergoing RPN using the daVinci SP compared to the Xi by MUSIC-KIDNEY surgeons. METHODS: MUSIC-KIDNEY is a statewide quality improvement (QI) collaborative that maintains a prospective registry of newly diagnosed T1RM. All data regarding patients undergoing RPN within a MUSIC-KIDNEY practice between October 2020 and August 2023 were collected. Patient, operative, and post-operative data were compared between patients who received SP and Xi RPN.RESULTS: A total of 323 RPNs were completed across 4MUSIC practices by 6 urologists. Of these, 122 (38%) used the daVinciSP platform (Table 1). Tumor characteristics (size, complexity) were similar, with more complex cysts in the SP group (24% vs. 12%,p[0.02). When comparing peri-operative outcomes, SP cases had significantly shorter operative time (141 vs. 181 minutes, p<0.001),lower rates of warm ischemia time ≥30 minutes (3.4% vs. 13.2%,p[0.01), and lower rates of hospital stay >2 days (4.9% vs. 14%,p[0.008). Surgeons performing SP RPN utilized the retroperitoneal approach significantly more than transperitoneal (80% vs. 6.0%,p<0.001). Opioid-free discharge was more common after SP RPN(66% vs. 17%, p<0.001). At 30 days, the rates of ED visits (10% vs.13%, p[0.43) and readmission (5.0% vs. 6.6%, p[0.52) were not statistically different. CONCLUSIONS: MUSIC-KIDNEY's initial experience with SPRPN demonstrates procedural safety comparable to multi-port and facilitation of retroperitoneal approach. Potential advantages include lower operative time, hospital stay, and opioid prescription after discharge. Limitations include small number of surgeons and cases using SP

Volume

211

Issue

5S

First Page

e715

Comments

American Urological Association Annual Meeting, May 3-6, 2024, San Antonio, TX

DOI

10.1097/01.JU.0001008912.25331.d7.11

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