Presentation Authors: Juan Garisto*, Riccardo Bertolo, Mohamed Eltemamy, Jihad Kaouk, Cleveland, OH
Introduction: The FDA approved da Vinci SP (Intuitive Surgical, Sunnyvale, CA) surgical system was developed specifically to facilitate single-site surgery, with the ideal aim to further reduce the invasiveness. We aimed to describe the technique of pure single-site trans-peritoneal robotic partial nephrectomy using the novel da Vinci SP surgical system.
Methods: Three consecutive patients who were diagnosed with contrast-enhanced renal masses amenable of partial nephrectomy were counseled and accepted to undergo robot-assisted partial nephrectomy performed by using the SP Surgical System. Data collection received institutional review board approval (IRB 13-780). Subjects were provided with informed consent explaining the adoption of the novel surgical platform. The procedures were performed by reproducing the steps of the standard institutional multi-arms robotic approach to partial nephrectomy.
Results: The surgeries were successfully performed. There was no need for conversion to standard multi-ports robotic approach nor need for additional ports placement. All the procedures were completed according to a pure single-site approach (no extra transabdominal ports were placed). No intraoperative complications occurred. The total robotic operative time averaged 180 min. The warm ischemia time averaged 25 min. Blood loss averaged 180 mL. All patients had negative parenchymal margins.
Conclusions: The feasibility of pure single-site transperitoneal robot-assisted partial nephrectomy using the novel SP surgical system is reported herein. Further studies are needed to confirm our results on a larger sample size. Comparative studies versus standard multiport robotic surgery are awaited.