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Inicio Actas Urológicas Españolas (English Edition) Single-port robot-assisted retroperitoneal surgery: A feasible approach
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Vol. 46. Issue 10.
Pages 653-657 (December 2022)
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Vol. 46. Issue 10.
Pages 653-657 (December 2022)
Surgical Technique
Single-port robot-assisted retroperitoneal surgery: A feasible approach
Cirugía retroperitoneal asistida por robot por puerto único: un abordaje factible
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D. Vazquez-Martul
Corresponding author
, J.L. Ponce Diaz-Reixa, A. Barbagelata-Lopez, V. Chantada-Abal
Servicio de Urología, Hospital Universitario de A Coruña, A Coruña, Spain
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Abstract
Introduction

The concept of surgery through a single incision has been pursued in the field of minimal invasion for the treatment of different pathologies. This, added to a retroperitoneal approach, implies less aggression for the patient at different levels. We describe the first cases of single-port robot-assisted retroperitoneal surgery (SP-RARS) in our country using the da Vinci Xi® system.

Material and methods

We present two cases of patients with right adrenal masses larger than 4 cm. The first case was a 55-year-old woman with an incidental diagnosis of angiomyolipoma, and the second case was a 62-year-old man with a non-functioning adrenal adenoma. Both cases were operated through a single 4-cm subcostal incision using the da Vinci Xi® system, annulling arm 4 without reallocating laterality on the surgeon’s console.

Results

Both surgeries were performed with console times of 75 and 150 min, respectively, with access and docking times below 30 min. Bleeding was less than 100 cc in both surgeries without the need to make accessory incisions or leave a drainage tube. The surgical specimens were removed through the same initial incision without the need for enlargement. Postoperative intravenous analgesia was not necessary in any case (VAS 0) and hospital stay was less than 24 h in both patients without reporting any complications.

Conclusions

SP-RARS is a feasible approach using the da Vinci Xi® system.

Keywords:
Single port
Single site
LESS
Robotic surgery
Adrenal
Retroperitoneal
Resumen
Introducción

La cirugía mediante una única incisión ha sido un concepto perseguido en el campo de la mínima invasión para el tratamiento de diferentes patologías. Este concepto sumado a un abordaje retroperitoneal puede suponer una disminución de la agresión al paciente a diferentes niveles. Describimos los primeros casos de cirugía retroperitoneal asistida por robot mediante puerto único (SP-RARS).

Material y métodos

Presentamos dos casos de pacientes con masas suprarrenales derechas con un tamaño superior a 4 cm. El primer caso se trataba de una mujer de 55 años con diagnóstico incidental de angiomiolipoma y en el segundo caso un varón de 62 años con adenoma suprarrenal no funcionante. Ambos casos se operaron a través de una única incisión subcostal de 4 cm mediante el sistema da Vinci Xi®, anulando el brazo 4 sin realizar reasignaciones de lateralidad en consola.

Resultados

Ambas cirugías se realizaron con tiempos de consola de 75 y 150 minutos respectivamente con tiempos de acceso y acoplamiento robótico inferiores a 30 minutos. El sangrado fue inferior a 100 cc en ambas cirugías sin necesidad de realizar incisiones accesorias o dejar tubo de drenaje. Las piezas quirúrgicas fueron extraídas por la misma incisión sin necesidad de ampliación. En ningún caso fue necesaria analgesia intravenosa postoperatoria (EVA 0) y la estancia fue inferior a 24 horas en ambos pacientes sin reportarse ninguna complicación.

Conclusiones

SP-RARS es un abordaje factible a través del sistema da Vinci Xi®.

Palabras clave:
Single port
Single site
LESS
Robotic surgery
Adrenal
Retroperitoneal

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