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Implementation of single-port robotic urologic surgery: experience at a large academic center

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Abstract

The Single-Port (SP) robotic system is increasingly being implemented in the United States, allowing for several minimally invasive urologic procedures to be performed. The present study aims to describe our single-center experience since the adoption of the SP platform. We retrospectively collected and analyzed consecutive SP cases performed at a major teaching hospital in the Midwest (Rush University Medical Center) from December 2020 to December 2023. Demographic variables were collected. Surgical and pathological outcomes were analyzed in the overall cohort and for each type of procedure. The study timeframe was divided into two periods to assess the evolution of SP technical features over time. In total, 160 procedures were performed, with robot-assisted radical prostatectomy (RARP) being the most common (49.4%). Overall, 54.4% of the procedures were extraperitoneal, with a significantly higher adoption of this approach in the second half of the study period (30% vs 74.3%, p < 0.001). A “plus one” assistant port was adopted in 38.1% of cases, with a shift towards a “pure” single-port surgery in the most recent procedures (21.1% vs 76.7%, p < 0.001). The median LOS was 33.5 h (30–48), with a rate of any grade and CD ≥ 3 postoperative complications of 9.4% and 2.5%, respectively, and a 30-day readmission rate of 1.9%. SP robotic surgery can be safely and effectively implemented for various urologic procedures. With increasing experience, the SP platform allows shifting away from transperitoneal procedures, potentially minimizing postoperative pain, and shortening hospital stay and postoperative recovery.

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Data availability

The database and the raw results of the data analysis are available upon reasonable request to the corresponding author.

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Funding

The authors have no funding to declare.

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Authors and Affiliations

  1. Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA

    Francesco Ditonno, Antonio Franco, Leslie Claire Licari, Eugenio Bologna, Celeste Manfredi, David O. Katz, Jonathan H. Huang, Kalyan C. Latchamsetty, Christopher L. Coogan, Edward E. Cherullo, Alexander K. Chow, Srinivas Vourganti & Riccardo Autorino

Authors
  1. Francesco Ditonno
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  2. Antonio Franco
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  3. Leslie Claire Licari
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  4. Eugenio Bologna
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  5. Celeste Manfredi
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  6. David O. Katz
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  13. Riccardo Autorino
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Contributions

FD, EB, and LCL contributed to manuscript writing/editing and data analysis. CM, AF, and DOK contributed to data collection and manuscript editing. JH, KCL, CLC, EEC, AKC, and SV contributed to data collection and revision of the work for important intellectual content. RA contributed to supervision, project development/management, data collection and manuscript revision. All authors read and approved the final version of the manuscript, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Riccardo Autorino.

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Ethical approval

This study was conducted in accordance with the Declaration of Helsinki on ethical principles for medical research involving human subjects. It obtained exempt status after being reviewed by the local Ethics Committee. All patients provided written informed consent for the inclusion of their data in the database and for their use for scientific research purposes.

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Ditonno, F., Franco, A., Licari, L.C. et al. Implementation of single-port robotic urologic surgery: experience at a large academic center. J Robotic Surg 18, 119 (2024). https://doi.org/10.1007/s11701-024-01884-z

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