Robot-Assisted Radical Prostatectomy: The Impact of Patient Positioning and Surgical Access on Intraoperative Anesthesiologic Parameters.

Introduction: To evaluate the role of supine extraperitoneal single-port radical prostatectomy on intraoperative ventilatory and cardiovascular parameters and on surgical outcomes compared with a cohort of patients treated with the Trendelenburg-associated transperitoneal approach.

Methods: Data from all consecutive patients who underwent radical prostatectomy between September 2019 and January 2024 were prospectively collected and retrospectively analyzed. Patients were divided into 2 groups based on the surgical approach: single-port supine extraperitoneal (SP-EP-RARP) and multi-port or single-port transperitoneal (MP-TP-RARP or SP-TP-RARP) radical prostatectomy.

Single-port Robot-assisted Ureteral Reimplantation via Low Anterior Access: Step-by-step Procedure and Preliminary Comparative Results.

Background And Objective: Multiport robotic management of distal ureteral strictures is still burdened by the mandatory transperitoneal approach and the steep Trendelenburg patient position. Our aim was to describe the largest series of patients treated with single-port robot-assisted ureteral reimplantation (SP-RAUR) via a supine extraperitoneal approach, with a focus on the surgical technique, perioperative surgical outcomes, and functional results.

Methods And Surgical Procedure: Clinical and surgical data for all consecutive adult patients treated with SP-RAUR between January 2021 and September 2023 were prospectively collected.

Single-Port Versus Multi-Port Robotic Radical Prostatectomy in Elderly Patients.

: Single-port radical prostatectomy (SP-RARP) has been demonstrated to be a feasible and safe procedure, even in older patients. This study aims to compare multi-port radical prostatectomy (MP-RARP) with SP-RARP, with a particular focus on elderly patients. : Patients who underwent SP-RARP or MP-RARP between January 2018 and December 2023 were retrospectively analyzed.

Retroperitoneal single port vs. transperitoneal multiport robot assisted partial nephrectomy in patients with highly hostile abdomen: comparative analysis from a tertiary care center.

Background: The aim of this study was to explore perioperative and functional outcomes in a cohort of patients with highly hostile abdomens treated with retroperitoneal (RP) single port vs transperitoneal multiport robot assisted partial nephrectomy.

Methods: Clinical and surgical data of all consecutive patients treated with transperitoneal multiport and RP single-port robot assisted partial nephrectomy between March 2019 and January 2024 were prospectively collected and retrospectively analyzed. The presence of "hostile abdomen" was defined as personal history of at least one major abdominal surgery.

A Single Port (SP) Approach Reduces the Risk of Postoperative Complications in Elderly Patients Undergoing Robotic-Assisted Partial Nephrectomy (RAPN).

Introduction: In recent years, due to the increasing life expectancy and the growing popularity of nephron sparing strategies (NSS), more elderly and frail patients are undergoing Robotic-Assisted Partial Nephrectomy (RAPN) for the treatment of localized Renal Cell Carcinoma (RCC). A Single Port Approach has demonstrated itself to reduce estimated blood loss (EBL), complication rates, and length of stay (LOS). In the present study, we aim to compare perioperative and postoperative outcomes of SP RAPN and Multi Port (MP) RAPN, with a focus on elderly patients.

Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy.

There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated.

Optimizing Prostate Cancer Surgery for Seniors: Single-Port Robotic-Assisted Platform.

The Da Vinci single-port (SP) platform is being used more frequently in radical prostatectomy (RP). In this study we aimed to compare the complications and oncological outcomes of the Da Vinci SP platform in robotic-assisted radical prostatectomy (SP-RARP) between elderly and young age-groups and to further examine differences between young-old and old-old patients. Data from 193 patients who underwent SP-RARP between December 2018 and June 2024 were analyzed.

Transperitoneal versus low anterior access single-port pyeloplasty: surgical and functional outcomes from a tertiary referral center.

Background: Transperitoneal approach to robot-assisted pyeloplasty (RAP) have been preferred in the last decades because of the use of multi-port robotic platforms. However, this approach is linked to notable issues, such as pneumoperitoneum and lateral decubitus position, which is associated with potential soft tissues injuries, and it is a time-consuming procedure. Single-port (SP) platform was introduced to potentially address these issues.

Development and validation of a novel comorbidity score specific for prostate cancer patients treated with robotic platform and its implication on DaVinci single-port system.

To develop and validate a novel Comorbidity score for Robotic Surgery (CRS) in predicting severe complications after robot-assisted radical prostatectomy (RARP). Furthermore, we investigated the impact of the surgical platform (Multi-Port - MP vs Single-Port - SP) according to this score. We included 2085 ("development cohort") and 595 ("validation cohort") patients undergoing RARP at two tertiary referral centers between 2014 and March 2024 in a retrospective study.

Learning Curve for Single-port Robot-assisted Urological Surgery: Single-center Experience and Implications for Adoption.

Background And Objective: Understanding the learning curve for the da Vinci single-port (SP) surgical robot is crucial for adoption, training, and enhancement of surgical safety and efficiency. Our aim was to assess the impact of both overall experience (O-EXP) and procedure-specific experience (PS-EXP) on perioperative outcomes across various SP surgeries.

Methods: We analyzed data for 387 consecutive SP surgeries conducted by a high-volume surgeon from December 2018 to July 2023.

Pelvic Lymph Node Dissection: A Comparison Among Extraperitoneal Single-port and Transperitoneal Multiport Radical Prostatectomy-A Single-center Experience.

Background And Objective: The role of pelvic lymph node dissection (PLND) for prostate cancer is still controversial. This study aims to compare the outcomes of PLND between extraperitoneal single-port (SP eRARP) and transperitoneal multiport (MP tRARP) robotic-assisted radical prostatectomy.

Methods: This was a retrospective analysis from our single-center database for patients who underwent SP eRARP or MP tRARP with PLND between 2015 and 2023.

The atlas of supine single port extraperitoneal access.

Introduction: The introduction of Single-Port (SP) platform opened the field to new surgical options, allowing to perform major urological robot-assisted procedures extraperitoneally and with a supine patient positioning (1-3). Nevertheless, a comprehensive description of different supine access options is still lacking (4-6). In this light, we provided a step-by-step guide of SP extraperitoneal supine access options also exploring preliminary surgical outcomes.

Surgical outcomes of novel retroperitoneal low anterior vs posterior and transperitoneal access in single-port partial nephrectomy.

Purpose: Single-Port Robot-Assisted Partial Nephrectomy (SP-RAPN) can be performed by transperitoneal and retroperitoneal approaches. However, there is a lack of surgical outcomes for novel Retroperitoneal Low Anterior Access (LAA) in SP-RAPN. The study compared outcomes of the standard approach (SA), considering transperitoneal (TP) and posterior retroperitoneal (RP) access vs LAA in SP-RAPN series.

Single-Port Transvesical Vesico-Vaginal Fistula Repair: An Initial Experience.

Introduction: Vesicovaginal fistula (VVF) is the most common urogenital fistula due to iatrogenic cause, primarily associated with gynecologic surgery (1). Although both conservative and surgical management may be considered, the optimal treatment is still uncertain and several studies were published using different techniques (open, laparoscopic or robotic) and approaches (extravesical, transvesical or transvaginal) (2-5). In this context, we aim to report our initial experience repairing VVF with Single-Port (SP) Transvesical (TV) access.

Single Port Radical Prostatectomy as a Viable Option for Highly Complex Patients: A Single Center Experience.

Objective: To explore the safety and feasibility of the Da Vinci single-port (SP) platform in robotic-assisted radical prostatectomy (SP-RARP), aiming to provide a viable option for patients with surgical and medical complexities that might otherwise limit their access to common minimally invasive technique.

Methods: Data from 60 medically and surgically highly complex patients undergoing SP-RARP between December 2018 and December 2023 were analyzed. Variables included patient characteristics, surgical history, intraoperative and postoperative outcomes.

Versatility of Single Port Retroperitoneal Low Anterior Access: Early Outcomes in Multiple Procedures.

This study aimed to assess early outcomes of the single port (SP) robotic low anterior access (LAA) for all upper urinary tract surgeries. In addition, it aimed to explore the impact of clinical factors, notably Body Mass Index (BMI), on post-operative outcomes and length of hospital stay. Overall, 76 consecutive patients underwent SP robotic surgery with LAA involving all upper urinary tract pathologies, with data collected prospectively.

Rearrangement of the Guy's stone score improves prediction of stone-free rate after percutaneous nephrolithotomy.

Objective: We propose a modification of the original Guy's Stone Score (GSS) to hold on 20 % of prognostic discrimination among groups which makes this score a more reliable resource for risk assessment in patients undergoing percutaneous nephrolithotomy (PCNL).

Material And Methods: Historical cohort of 126 patients undergoing PCNL from December 2010 to November 2014 was included in the survey. Every patient was classified according to the original GSS.

[Stone free rate assesment after percutaneous nephrolithotomy using nephrolitometric nomogram].

Background: Percutaneous nephrolithotomy remains the standard of care for kidney stones larger than 2cm. Therefore, setting a prognosis for complete stone resolution through this method is essential. The prognostic tools available have limited prediction.

[Intrarectal povidone-iodine to reduce the risk of genitourinary infections after transrectal prostate biopsy].

Background: The aim of this study is to compare two different preparations in patients undergoing transrectal prostate biopsies samples (TPBS) and assess the prevalence of genitourinary infections (GUI).

Methods: A historical cohort of patients undergoing TBPS for suspected prostate cancer. Two groups were compared: one with endorectal lubricant jelly and another with the addition of a povidone-iodine lubricating jelly.