Is it simpler with single-port?. A comparative analysis of single-port robot-assisted simple and radical nephrectomy in a tertiary referral center.

Abstract

Background: Simple nephrectomy (SN), a procedure performed for benign kidney conditions, can be more challenging and complicated than radical nephrectomy (RN). With the widespread adoption of minimally invasive surgery, robotic platforms have also been introduced for SN. In this study, we aim to compare perioperative outcomes and complications between single-port (SP) robotic-assisted (RA) SN and RN in a tertiary referral center.

Methods: Data from 63 consecutive patients who underwent SP-RASN and SP-RARN between December 2018 and December 2024 at a single center, performed by a single surgeon, were evaluated. We compared baseline patient characteristics, intraoperative and postoperative outcomes.

Results: A total of 33 SP-RARN and 30 SP-RASN were included. There were no differences between the two groups in terms of operation time and estimated blood loss (P=0.741, P=0.587, respectively). None of the patients in the SP-RASN group required conversion to open surgery, and no intraoperative complications were observed. In the SP-RASN group, the median length of hospital stay (LOS) was 0.5 (0-1.25) days, and the same-day discharge (SDD) rate was 50%. The numbers of patients with Clavien grade 1 and grade 2 complications for SP-RASN was 3 (10%) and 4 (13.3%), respectively. There was a 0% incidence of major postoperative complications (≥Clavien-Dindo grade 3). LOS, SDD, postoperative complications and readmission rates were similar between groups (P=0.120, P=0.064, P=0.854, P=0.498, respectively).

Conclusions: SP-RASN is a feasible option for the management of benign renal conditions/diseases, offering a low postoperative complication rate and the possibility of SDD.