Retroperitoneal Laparoendoscopic Single-Incision Radical Nephrectomy Without Special Platforms: A Single-Center Initial Experience

Robot-Assisted Nephrectomy Using the Newly Developed EDGE SP1000 Single-Port Robotic Surgical System: A Feasibility Study in Porcine Model

Objectives: To evaluate the feasibility and safety of the EDGE SP1000 single-port robotic platform by performing nephrectomy in live porcine model. Materials and Methods: Robotic nephrectomy was performed on sample group of five gilts using the EDGE SP1000 single-port robotic system. The continuous vital signs of all gilts were monitored throughout the operation to examine the safety of the operation. Data regarding surgical complications and technical difficulties throughout the operation were recorded for future evaluation. Finally, the survival of the sample gilts 2 weeks after the operation were recorded. Results: The robot-assisted nephrectomy yielded an impressive result that all sample gilts survived after 2 weeks. Furthermore, neither surgical complications nor technical difficulties were encountered during the operation. The average duration to establish the operation channel was 12.4 ± 1.52 minutes, the average time taken to install EDGE SP1000 single-port robotic system was 2.8 ± 0.84 minutes, the average time to dissociate and remove the kidney was 47 ± 5.61 minutes, and average total operational duration was 71 ± 5.24 minutes. Most importantly, the surgeon and assistant who were using the system found it convenient and performed excellently during the operation. Conclusions: This study shows that the EDGE SP1000 single-port robotic surgical system is safe and feasible for the use of nephrectomy in gilts. Our further research will expand the application of the EDGE SP1000 system to other urologic procedures and accumulate more preclinical data for further clinical trial.

Laparoendoscopic single-site nephrectomy versus conventional laparoendoscopic nephrectomy for kidney tumor: a systematic review and meta-analysis

With the increasing application of laparoendoscopic single-site nephrectomy (LESS-N) in kidney tumor, accumulating studies compared it with conventional laparoendoscopic nephrectomy (CL-N). However, controversial outcomes were reported. Hence, this meta-analysis was carried out to clarify these issues. Online databases PubMed, EMBASE and the Cochrane Library were searched comprehensively for eligible studies published before 24 July 2018. Odds ratios (ORs) or standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were collected for evaluating the pooled results of relevant outcomes. Ultimately, 13 eligible articles were enrolled. Meanwhile, compared with CL-N, LESS-N was related to a longer operation time (SMD: 0.40; 95% CI, 0.23–0.58; P=0.000), a shorter length of hospital stay (LOS) (SMD: −0.32; 95% CI, −0.62 to −0.02; P=0.034), a lower visual analog scale (VAS) score (SMD: −0.89; 95% CI, −1.22 to −0.56; P=0.000) and a lower analgesic requirement (SMD: −0.55; 95% CI, −0.87 to −0.23; P=0.001). There was no statistical difference in the postoperative day of oral intake, estimated blood loss (EBL), conversion rate, perioperative complications, intraoperative complications, postoperative complications, minor complications and major complications between LESS-N and CL-N. Patients with LESS-N for kidney tumor could have a longer operation time and shorter LOS, and meanwhile could need less analgesics and suffer less pain after LESS-N.