Pure Single-Site Robot-Assisted Partial Nephrectomy Using the SP Surgical System: Initial Clinical Experience

Objectives: To describe the technique of pure single-site trans-peritoneal robotic partial nephrectomy using the da Vinci SP surgical system. Methods: Three consecutive patients who were diagnosed with contrast-enhanced renal masses amenable of partial nephrectomy were scheduled for robot-assisted partial nephrectomy to be performed using the SP Surgical System. Data collection received Institutional Review Board Approval (IRB 13-780). Subjects were provided with informed consent explaining the adoption of the novel surgical platform. The procedures were performed by reproducing the steps of the standard institutional multiarms robotic approach to partial nephrectomy. Results: The surgeries were successfully performed. There was no need for conversion to standard multiports robotic approach nor need for additional ports placement. All the procedures were completed according to a pure single-site approach. No intraoperative complications occurred. The total robotic operative time averaged 180 minutes. The warm ischemia time averaged 25 minutes. Blood loss averaged 180 mL. One patient had postoperative acute bleeding and underwent angioembolization. All patients had negative surgical margins. Conclusion: The feasibility of pure single-site transperitoneal robot-assisted partial nephrectomy using the novel SP surgical system is demonstrated. Further studies are needed to confirm the results reported herein.