Session: MP68: Surgical Technology & Simulation: Instrumentation & Technology II
MP68-07: A Comparison of Transperitoneal and Retroperitoneal Approach in Patients undergoing Single-Port Robotic-Assisted Partial Nephrectomy: A Report from the Single Port Advanced Research Consortium (SPARC)
Introduction: Single-Port (SP) robotic-assisted partial nephrectomy (RAPN) has been established as a reasonable alternative to the (MP) multiport platform motivated by the potential to regionalize surgery and decrease morbidity. However, there is a dearth of literature on its efficiency and safety for either the transperitoneal (TP) or retroperitoneal (RP) approach. We sought to compare the perioperative and post-operative outcomes of the TP and RP approach for the SP RAPN. Methods: Using data from the Single Port Advanced Research Consortium (SPARC) database, we conducted a retrospective analysis of 219 patients who underwent SP RPN for a renal mass between 2019 and 2022 (121 [55.25%] TP, 98 [44.75%] RP). Baseline characteristics, perioperative and postoperative data were compared between both approaches using ?² test, Fisher exact test, Mann Whitney U test, student’s t test. Results: Of the 148 patients in this study, 76 (51.35%) were male and the mean (SD) age was 60 (11) years. The RP group had a significantly higher proportion of posterior tumors [54 (55.10%), RP vs. 28 (23.14 %%), TP; p<0.001], while other baseline characteristics were comparable between the two approaches. Compared to transperitoneal approach, retroperitoneal approach had similar ischemia time (18 [SD=9] mins vs. 18 [SD=11] mins, p=0.898), operative time (147[SD=67] mins vs. 146 [SD=70] mins, p=0.925), estimated blood loss EBL (76 ml [SD=100] vs. 98 ml[SD=124], p=0.167), length of stay (1.07 [SD=2.25] day vs. 1.33 [SD=1.05] day, p=0.270), overall complication rate (5 [5.10%] vs 7 [5.79%], and major complication rate (2 [2.04%] vs. 2 [1.65%], p=1.000). No difference was observed in positive surgical margin rate (p=0.472) or delta eGFR (p=0.273). Conclusions: Trans peritoneal and retroperitoneal SP RAPN yielded similar perioperative and postoperative outcomes. The SP platform is a safe platform to perform transperitoneal and retroperitoneal RAPN. SOURCE OF Funding: None
