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Single-Port Robotic Partial Nephrectomy via Low-Anterior Access Is Safe and Feasible: Experience from a Single-Center Cohort
Guilherme Garcia Barros, MD
1, Nathaniel F. Hansen, MD
2,
Muhieddine Labban, MD2, Zhiyu (Jason) Qian, MD
2, Christopher P. Dall, MD
2, Jose Ignacio Nolazco, MD
2, Steven L. Chang, MD, MS
2, Timothy N. Clinton, MD
2.
1University of São Paulo, São Paulo, Brazil,
2Brigham and Women's Hospital, BOSTON, MA, USA.
BACKGROUND: Minimally invasive partial nephrectomy has become the standard treatment for small renal masses, offering a safe surgical approach with excellent oncologic outcomes. More recently, single-port (SP) robotic surgery, utilizing only one surgical incision, has emerged as an even less invasive option for patients. However, there have been few reports on the safety of this approach. We aim to study short-term surgical outcomes of SP partial nephrectomies performed at our institution.
METHODS: A retrospective review was conducted on patients who underwent SP partial nephrectomy between February 2024 and March 2025 at two sites of our institution. Procedures were performed by two surgeons using a standardized technique through a low-anterior 3 cm incision. Patients were placed in the supine position with a single flank bolster. Demographic, operative and complication data were collected from electronic medical records.
RESULTS: Sixty-two patients were included. Mean age and BMI were 62.2 ± 11.9 years and 28.9 ± 6.1 kg/m², respectively. Tumors were right-sided in 56.5% and left-sided in 43.5%. Tumor mean size was 2.7 ± 1.3 cm. Mean operative time was 146.4 ± 43.6 minutes, warm ischemia time 27.4 ± 11.9 minutes, and median blood loss 50 mL (IQR 78.8). Mean hospital stay was 1.1 ± 0.4 days. One case required conversion to a transperitoneal approach. No transfusions were needed. Minor complications (Clavien-Dindo I, 4.8%) included incision pain, cutaneous rash, and self-limited hematuria. Major complications (Clavien-Dindo IIIb, 3.2%) consisted of one incisional hernia and one retroperitoneal hematoma with urinary leak. The latter case required readmission (n=1, 1.6%) for percutaneous drainage. No significant predictors of complications were identified. No deaths were recorded.
CONCLUSIONS: SP partial nephrectomy is a safe and feasible minimally invasive option, with low complication rates and consistent perioperative outcomes across diverse patient profiles.
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