V04-07 Single Port Robotic Retroperitoneal Partial Nephrectomy Performed via a Low Anterolateral Incision

You have accessJournal of UrologyAdrenal/Renal Oncology I (V04)1 May 2024V04-07 SINGLE PORT ROBOTIC RETROPERITONEAL PARTIAL NEPHRECTOMY PERFORMED VIA A LOW ANTEROLATERAL INCISION Nicolas A. Soputro, Roxana Ramos-Carpinteyro, Adriana M. Pedraza, Jaya S. Chavali, Carter Mikesell, and Jihad Kaouk Nicolas A. SoputroNicolas A. Soputro , Roxana Ramos-CarpinteyroRoxana Ramos-Carpinteyro , Adriana M. PedrazaAdriana M. Pedraza , Jaya S. ChavaliJaya S. Chavali , Carter MikesellCarter Mikesell , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001009444.59519.d3.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The benefits of low anterolateral incision have been previously demonstrated, including improved patient comfort, enhanced postoperative recovery as facilitated by the preservation of accessory respiratory muscles, as well as cosmesis. This video sought to provide a technical description of the novel application of the incision for robotic retroperitoneal partial nephrectomy (RPN) performed using the purpose-built Single Port (SP) platform. METHODS: A 3 cm incision was made at two fingers breadth above the superior pubic ramus. Blunt dissection using the surgeon's gloved finger was performed to open the retroperitoneal space for the subsequent placement of a purpose-built SP Access Kit. Following robot docking and entry into the retroperitoneum, the psoas major muscle was visualized and dissections were continued along the ureter towards the renal hilum. Low-pressure Scanlan bulldog clamps were used for vascular control. Other surgical steps, including intraoperative ultrasound, tumor excision, and renorrhaphy were similar to other robotic RPN approaches. RESULTS: The procedure was successfully completed in a 69-year-old man with an asymptomatic, left upper pole posterior renal mass. Total operating time was 2 hours and 48 minutes, with a warm ischemia time of 25 minutes and an estimated blood loss of 15 mL. Negative surgical margin was achieved and there was no perioperative complication. The patient was discharged six hours following his surgery without requiring any opioid analgesia. The incision has since been successfully applied for various tumor locations, including anterior, posterior, and lateral, without the need for conversion or additional ports. CONCLUSIONS: Low anterolateral incision can be safely utilized for SP RPN involving various tumor locations. Our early experience demonstrated improved perioperative outcomes favoring opioid-sparing outpatient procedures. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e198 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nicolas A. Soputro More articles by this author Roxana Ramos-Carpinteyro More articles by this author Adriana M. Pedraza More articles by this author Jaya S. Chavali More articles by this author Carter Mikesell More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...