Abstract：
Introduction and Objective: Since its Food and Drug Administration (FDA) approval in 2018, Intuitive Surgical DaVinci single port (SP) robotic platform has been an effectively used technology for multiple urologic procedures. The purpose of this study is to share our early intraoperative and perioperative outcomes and potential benefits for performing a lower anterior access (LAA) incision for SP robot-assisted partial nephrectomy (SP-RAPN). The LAA incision enables performing a trans- or retroperitoneal (RP) approach through the same incision and eases the transition to a RP approach. Methods: This study is a prospective review of 78 SP-RAPN cases between March 2021 and January 2023 by an experienced robotic surgeon. A single 2-3 cm oblique incision parallel to the external oblique muscle, one-third of the distance between the iliac crest and umbilicus, was used to insert the multichannel port to perform the RAPN. We extracted intra- and perioperative data of these patients to share the outcomes of this approach. Results: SP-RAPN was effectively completed in 78 patients (38 females and 40 males) without conversion to open or laparoscopic techniques. The mean age was 61.2 ± 12.1 years. The mean tumor size was 3.0 ± 1.2 cm, 43 were right-sided masses, and 35 were left sided. The R.E.N.A.L Nephrometry score ranged from (4-11) with an average of 7.0 ± 1.9. Average operating room time was 90.5 ± 24.6 minutes, estimated blood loss was 88.3 ± 134 mL, and length of stay of 1.07 ± 0.7 days. Of the 78 cases, 40 required clamping of the renal artery with average warm ischemia time of 19.4 ± 6.7 minutes in patients who underwent clamping. No complications in all of 78 patients. Conclusions: This study demonstrates the feasibility and reproducibility of SP-RAPN using a LAA incision. This incision provides a standardized approach for surgeons to transition to the RP approach using the SP platform.
摘要：
目的：自2018年FDA批准以来，直观手术达芬奇单端口（SP）机器人平台已成功用于多种泌尿外科手术。这项研究的目的是分享我们的早期术中和围手术期结果以及在单孔机器人辅助肾部分切除术（SP-RAPN）中进行腹膜后前路（LARA）切口的潜在益处。LARA切口能够通过同一切口进行经腹膜或腹膜后入路，并简化了向腹膜后入路的过渡。
方法：本研究是一位经验丰富的机器人外科医生在2021年3月至2023年1月3日期间对78例SP部分肾切除术病例的前瞻性回顾。平行于外斜肌的单个2-3厘米斜切口，髂骨和脐部之间距离的三分之一,用于插入多通道端口以执行RAPN。我们提取了这些患者的围手术期和围手术期数据，以分享这种方法的结果。
结果：SP-RAPN在78例患者（38名女性和40名男性）中成功完成，没有转换为开放或腹腔镜技术。平均年龄为61.2±12.1岁。平均肿瘤大小为3.0±1.2cm，43人是右侧群众，35个是左边的.R.E.N.A.L肾病评分范围为（4-11），平均7.0±1.9。平均手术室时间为90.5±24.6分钟，估计失血量为88.3±134ml,住院时间为1.07±0.7天.40/78例患者需要夹闭肾动脉，平均热缺血时间为19.4±6.7min。78例患者均无并发症发生。
结论：本研究证明了使用LARA切口进行SP-RAPN的可行性和可重复性。该切口为外科医生提供了一种使用SP平台过渡到腹膜后方法的标准化方法。
方法：本研究是一位经验丰富的机器人外科医生在2021年3月至2023年1月3日期间对78例SP部分肾切除术病例的前瞻性回顾。平行于外斜肌的单个2-3厘米斜切口，髂骨和脐部之间距离的三分之一,用于插入多通道端口以执行RAPN。我们提取了这些患者的围手术期和围手术期数据，以分享这种方法的结果。
结果：SP-RAPN在78例患者（38名女性和40名男性）中成功完成，没有转换为开放或腹腔镜技术。平均年龄为61.2±12.1岁。平均肿瘤大小为3.0±1.2cm，43人是右侧群众，35个是左边的.R.E.N.A.L肾病评分范围为（4-11），平均7.0±1.9。平均手术室时间为90.5±24.6分钟，估计失血量为88.3±134ml,住院时间为1.07±0.7天.40/78例患者需要夹闭肾动脉，平均热缺血时间为19.4±6.7min。78例患者均无并发症发生。
结论：本研究证明了使用LARA切口进行SP-RAPN的可行性和可重复性。该切口为外科医生提供了一种使用SP平台过渡到腹膜后方法的标准化方法。
