Comparison of transperitoneal and retroperitoneal partial nephrectomy with single port robot.

PURPOSE: To investigate the efficacy and safety of single port robotic transperitoneal (TP) and retroperitoneal (RP) partial nephrectomy.

MATERIALS AND METHODS: From September 2021 to June 2022, 30 sequential cases of partial nephrectomy performed after a single port (SP) robot was introduced to our hospital were retrospectively analyzed. All patients were diagnosed with T1 renal cell carcinoma and operated by a single expert in conventional robot with a da Vinci SP platform.

RESULTS: A total of 30 patients underwent SP robotic partial nephrectomy, including 16 (53.33%) by TP and 14 (47.67%) by RP. Body mass index was slightly higher in the TP group (25.37 vs. 23.53, p-value = 0.040). Other demographic characteristics were not significantly different between the two groups. There was no statistically significant difference in ischemic time (727.41 ± 561.18 sec for TP and 698.56 ± 299.23 sec for RP, p-value = 0.812) or console time (67.97 ± 24.06 min for TP and 69.71 ± 28.66 min for RP, p-value = 0.724). There was no statistically significant difference in perioperative or pathological outcome either. Renal function calculated from DTPA was 103.33 ml/min/1.73m2 for TP and 101.33 ml/min/1.73m2 for RP (p-value = 0.214) postoperatively. It was 90.36 ml/min/1.73m2 for TP and 87.74 ml/min/1.73m2 for RP (p-value = 0.592) at 90 days after surgery.

CONCLUSION: SP robot partial nephrectomy can be performed effectively and safely regardless of the approach. Both TP and RP approaches offer similar perioperative and postoperative outcomes for T1 RCC.