Adoption of Single-Port Robotic Partial Nephrectomy Increases Utilization of the Retroperitoneal Approach: A Report from the Single-Port Advanced Research Consortium
<b><i>Introduction:</i></b> Retroperitoneal approach for robotic partial nephrectomy (PN) has been shown to offer shorter operative times and hospital stays without differences in complication rates compared with the transperitoneal approach. The single-port (SP) system may be better suited than multiport (MP) for challenges with the retroperitoneal approach such as narrow access geometry. We evaluated if the adoption of SP PN increased the utilization of retroperitoneal approach. <b><i>Methods:</i></b> We retrospectively reviewed an IRB-approved multi-institutional database of all PN from 2013 to 2023. The date of the first SP PN split the cohorts before and after SP adoption. The percentage of retroperitoneal and transperitoneal approach cases overall and for SP and MP was determined before and after adoption. Joinpoint analysis assessed changes in rates of the retroperitoneal approach. Logistic regression compared patient and tumor characteristics with retroperitoneal approach PN before and after adoption of SP. <b><i>Results:</i></b> Overall 1959 patients were evaluated, of which 654 were performed prior versus 1305 after SP adoption. There was an increased percentage of retroperitoneal approach after adoption, with 7.3% (48/654) before compared with 24.8% (324/1305) after adoption. The percentage of the retroperitoneal approach for SP PN was 52.8% (134/254), increasing over time with 75% (24/32) of SP in 2023 performed with a retroperitoneal approach. <b><i>Conclusion:</i></b> The retroperitoneal approach was used more frequently than the transperitoneal approach in the SP cohort. The adoption of SP increased the incidence of the retroperitoneal approach.
Authors
- Simone Crivellaro
- Kennedy E. Okhawere (ORCID: https://orcid.org/0000-0002-7165-0823)
- Roxana Ramos‐Carpinteyro (ORCID: https://orcid.org/0000-0002-5848-4357)
- Craig Rogers (ORCID: https://orcid.org/0000-0002-7781-6644)
- Indu Saini (ORCID: https://orcid.org/0000-0003-3983-913X)
- Reza Mehrazin (ORCID: https://orcid.org/0009-0007-8648-0410)
- Ashok K. Hemal (ORCID: https://orcid.org/0000-0001-8270-341X)
- Phillip M. Pierorazio (ORCID: https://orcid.org/0000-0003-0766-9981)
- Nirmish Singla (ORCID: https://orcid.org/0000-0001-9495-6983)
- James Porter (ORCID: https://orcid.org/0000-0001-9275-4552)
- Ruchir Chaturvedi
- Mubashir Billah (ORCID: https://orcid.org/0000-0003-3920-8987)
- Akshay Bhandari (ORCID: https://orcid.org/0000-0001-9684-3376)
- Ruben Sauer Calvo
- Ketan K. Badani (ORCID: https://orcid.org/0000-0002-5472-7294)
- Benjamin Inbeh Chung (ORCID: https://orcid.org/0000-0001-9660-2732)
- Nicolas Soputro (ORCID: https://orcid.org/0000-0002-5419-0327)
- Michael Raver (ORCID: https://orcid.org/0000-0002-5022-4948)
- Milan Patel
- Ahmed M. Mansour (ORCID: https://orcid.org/0000-0002-2510-3730)
- Michael Stifelman (ORCID: https://orcid.org/0000-0003-2361-6863)
- Ronney Abaza
- Mutahar Ahmed
- Jihad Kaouk
Institutions
- Cleveland Clinic (US)
- Hackensack University Medical Center (US)
- Johns Hopkins University (US)
- The University of Texas at San Antonio Health Science Center (US)
- Johns Hopkins Medicine (US)
- Rehabilitation Institute of Michigan (US)
- University of Illinois Chicago (US)
- Swedish Medical Center (US)
- Central Ohio Radiation Oncology (US)
- Mount Sinai Medical Center (US)
- Center for Discovery (US)
- Wake Forest University (US)
- University of Pennsylvania (US)
- Stanford University (US)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- Journal of Laparoendoscopic & Advanced Surgical Techniques
- Published
- 2025-02-01
- DOI
- https://doi.org/10.1089/lap.2024.0305
- Citations
- 9
- Primary Topic
- Renal cell carcinoma treatment
- Type
- article
- Field-Weighted Citation Impact
- 13.67