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Single-Port Robot-Assisted Dismembered Pyeloplasty With Mini-Pfannenstiel or Peri-Umbilical Access: Initial Experience in a Single Center.
Metadata
Journalurology1.924Date
2020 Jun 04
4 months ago
Type
Journal Article
Volume
2020-Sep / 143 : 147-152
Author
Lenfant L 1, Wilson CA 2, Sawczyn G 2, Aminsharifi A 3, Kim S 2, Kaouk J 4
Affiliation
  • 2. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
  • 3. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Sorbonne University, GRC n° 5, PREDICTIVE ONCO-UROLOGY, AP-HP, Hôpital Pitié-Salpiêtrière, Urology, Paris, France; Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran.
  • 4. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: [email protected]
Doi
PMIDMESH
Abstract
OBJECTIVE: To assess the feasibility and describe the surgical technique for single-port robotic-assisted laparoscopic pyeloplasty using the new da Vinci SP surgical platform (Intuitive Surgical Inc., Sunnyvale, CA), and to describe the approach through a mini-pfannenstiel incision.
METHODS: Data from a prospectively maintained single-institution database on all patients undergoing single-port robotic-assisted pyeloplasty between November 2018 and November 2019 were reviewed. Pyeloplasty was performed with the da Vinci SP system through a pure single site approach (except for the first patient). The initial procedures were performed through a midline incision and the technique evolved to a mini-pfannenstiel incision. Patient demographics, intraoperative data, post-operative data and surgical outcomes were collected.
RESULTS: Overall, 10 patients were included and underwent the procedure without intraoperative complications or conversion to an alternate approach. The patients' ages ranged between 11 and 75 years. Mean operative time was 166 minutes (interquartile range [IQR] 146-181) and EBL was minimal. Pfannenstiel incision was performed for 6 patients and 4 patients had a vertical midline incision. The only complication recorded was a postoperative urinary tract infection treated with antibiotics. The median postoperative hospital stay was 21 hours (7-24). Postoperative pain management after discharge was managed exclusively with non-opioid medication. Overall success rate defined as the absence of pain and renal obstruction on post-operative imaging at 3 months after surgery was 100%.
CONCLUSION: Single-port robotic-assisted laparoscopic pyeloplasty is a safe and feasible procedure through a mini-pfannenstiel incision.
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Urologyurology
Metadata
LocationUnited States
FromELSEVIER SCIENCE INC

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