Retroperitoneal Robot-Assisted Single-Port Laparoscopic Partial Nephrectomy: Initial Experience With the Da Vinci Si Robotic System

(1) Background: To present the initial experience in retroperitoneal robot-assisted single-port laparoscopic partial nephrectomy for renal cell carcinoma and evaluate its efficiency and safety. (2) Methods: Retrospectively analyzed four patients underwent retroperitoneal robot-assisted single-port laparoscopic partial nephrectomy in our hospital during September 2020 to December 2020. Patients who with renal cell carcinoma (T1b or T1c) were selected into our study. A multichannel port was inserted retroperitoneally through a 4-5cm incision. Preoperative, intraoperative and postoperative outcomes were finally recorded and analyzed. (3) Results: The median patient age was 62.0(range 49-68) year, the median body mass index was 23.0(range 21.3-24.2) kg/m 2 . No one had abdominal surgery history. All surgeries were successfully completed and none of them was changed to open surgery or added additional auxiliary channels. The median docking time was 16.5(range 15-25) minutes, the median operation time was 177.5(range 145-230) minutes, the median warm ischemia time was 19.0(range 15-25) minutes, the median estimated blood loss was 50.0(range 40-60) mL. No patient needed blood transfusion. The median postoperative fasting time was 3.5(range 1-5) days, the median catheter removal time was 5.5(range 5-7) days, and the median hospital stay was 7.0(6-8) days. None of the patients had intraoperative or postoperative complications. After 3 months of follow-up, there was no tumor recurrence in all four patients. (4) Conclusions: Retroperitoneal robot-assisted single-port laparoscopic partial nephrectomy is a feasible surgical method, but additional investigations are still needed to evaluate its safety and oncologic adequacy.