1
|
Huang D, Zeng H. Two-port (single incision plus one port) versus single-port laparoscopic totally extraperitoneal repair for inguinal hernia: a retrospective comparative study. Updates Surg 2024; 76:595-600. [PMID: 38070072 DOI: 10.1007/s13304-023-01716-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/20/2023] [Indexed: 04/05/2024]
Abstract
The aim of this study is to compare the feasibility and efficacy of two-port (single incision plus one port) laparoscopic totally extraperitoneal repair (TEP) with single-port TEP for the treatment of inguinal hernia. We performed a retrospective comparative study from a prospectively maintained database. A cohort of 229 patients with inguinal hernia who underwent TEP were included. Of these patients, 124 underwent two-port TEP and 105 underwent single-port TEP. Differences in surgical outcomes were compared. The mean operative time was shorter in the two-port TEP group compared to the single-port TEP group (55.3 ± 13.1 vs. 65.1 ± 16.6 min, P < 0.001). There was no significant difference between the two groups in terms of other surgical outcomes including postoperative pain, postoperative hospital stay, time to resume daily activities, cosmetic satisfaction and complications. Two-port TEP is associated with a shorter operative time compared to single-port TEP, while the other outcomes evaluated in this study appear to be comparable.
Collapse
Affiliation(s)
- Donghang Huang
- Department of Basic Surgery, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, 350001, People's Republic of China
| | - Huanhong Zeng
- Department of Basic Surgery, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, 350001, People's Republic of China.
| |
Collapse
|
2
|
Ditonno F, Franco A, Licari LC, Bologna E, Manfredi C, Katz DO, Huang JH, Latchamsetty KC, Coogan CL, Cherullo EE, Chow AK, Vourganti S, Autorino R. Implementation of single-port robotic urologic surgery: experience at a large academic center. J Robot Surg 2024; 18:119. [PMID: 38492003 DOI: 10.1007/s11701-024-01884-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/24/2024] [Indexed: 03/18/2024]
Abstract
The Single-Port (SP) robotic system is increasingly being implemented in the United States, allowing for several minimally invasive urologic procedures to be performed. The present study aims to describe our single-center experience since the adoption of the SP platform. We retrospectively collected and analyzed consecutive SP cases performed at a major teaching hospital in the Midwest (Rush University Medical Center) from December 2020 to December 2023. Demographic variables were collected. Surgical and pathological outcomes were analyzed in the overall cohort and for each type of procedure. The study timeframe was divided into two periods to assess the evolution of SP technical features over time. In total, 160 procedures were performed, with robot-assisted radical prostatectomy (RARP) being the most common (49.4%). Overall, 54.4% of the procedures were extraperitoneal, with a significantly higher adoption of this approach in the second half of the study period (30% vs 74.3%, p < 0.001). A "plus one" assistant port was adopted in 38.1% of cases, with a shift towards a "pure" single-port surgery in the most recent procedures (21.1% vs 76.7%, p < 0.001). The median LOS was 33.5 h (30-48), with a rate of any grade and CD ≥ 3 postoperative complications of 9.4% and 2.5%, respectively, and a 30-day readmission rate of 1.9%. SP robotic surgery can be safely and effectively implemented for various urologic procedures. With increasing experience, the SP platform allows shifting away from transperitoneal procedures, potentially minimizing postoperative pain, and shortening hospital stay and postoperative recovery.
Collapse
Affiliation(s)
- Francesco Ditonno
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Antonio Franco
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Leslie Claire Licari
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Eugenio Bologna
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Celeste Manfredi
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - David O Katz
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Jonathan H Huang
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Kalyan C Latchamsetty
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Christopher L Coogan
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Edward E Cherullo
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Alexander K Chow
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Srinivas Vourganti
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.
| |
Collapse
|
3
|
Ge S, Zeng Z, Li Y, Gan L, Meng C, Li K, Wang Z, Zheng L. Comparing the safety and efficacy of single-port versus multi-port robotic-assisted techniques in urological surgeries: a systematic review and meta-analysis. World J Urol 2024; 42:18. [PMID: 38197961 DOI: 10.1007/s00345-023-04711-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/24/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE Comparing the safety and efficacy of single-port (SP) versus multi-port (MP) robotic-assisted techniques in urological surgeries. METHODS A systematic review and cumulative meta-analysis was performed using PRISMA criteria for primary outcomes of interest, and quality assessment followed AMSTAR. Four databases were systematically searched: Embase, PubMed, The Cochrane Library, and Web of Science. The search time range is from database creation to December 2022. Stata16 was used for statistical analysis. RESULTS There were 17 studies involving 5015 patients. In urological surgeries, single-port robotics had shorter length of stay (WMD = - 0.63, 95% Cl [- 1.06, - 0.21], P < 0.05), less estimated blood loss (WMD = - 19.56, 95% Cl [- 32.21, - 6.91], P < 0.05), less lymph node yields (WMD = - 3.35, 95% Cl [- 5.16, - 1.55], P < 0.05), less postoperative opioid use (WMD = - 5.86, 95% Cl [- 8.83, - 2.88], P < 0.05). There were no statistically significant differences in operative time, positive margins rate, overall complications rate, and major complications rate. CONCLUSION Single-port robotics appears to have similar perioperative outcomes to multi-port robotics in urological surgery. In radical prostatectomy, single-port robotics has shown some advantages, but the specific suitability of single-port robots for urological surgical types needs to be further explored.
Collapse
Affiliation(s)
- Si Ge
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
- Department of UrologySchool of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Zhiqiang Zeng
- Department of UrologySchool of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Yunxiang Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China.
- Department of UrologySchool of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Lijian Gan
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Chunyang Meng
- Department of UrologySchool of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Kangsen Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Zuoping Wang
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Lei Zheng
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| |
Collapse
|
4
|
Dhanji S, Wang L, Liu F, Meagher MF, Saidian A, Derweesh IH. Recent Advances in the Management of Localized and Locally Advanced Renal Cell Carcinoma: A Narrative Review. Res Rep Urol 2023; 15:99-108. [PMID: 36879830 PMCID: PMC9985462 DOI: 10.2147/rru.s326987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/28/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose To review the current status of surgical and procedural treatments for renal cell carcinoma (RCC), focusing on oncological and functional outcomes, and the use of techniques for advanced disease over the last 10 years. Findings Partial nephrectomy (PN) has become the reference standard for most T1 and T2 masses. In cT2 RCC, PN exhibits oncological equivalence and improved functional outcomes compared to radical nephrectomy (RN). Additionally, emerging data suggest that PN may be used to treat cT3a RCC. The robot-assisted platform is increasingly used to treat locally advanced RCC. Studies suggest safety and feasibility of robotic RN and robotic inferior vena cava tumor thrombectomy. Additionally, single-port robot-assisted laparoscopic approaches are comparable to multiport approaches in select patients. Long-term data show that cryoablation, radiofrequency ablation, and microwave ablation are equipotent in management of small renal masses. Emerging data suggest that microwave may effectively treat cT1b masses.
Collapse
Affiliation(s)
- Sohail Dhanji
- Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Luke Wang
- Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Franklin Liu
- Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Margaret F Meagher
- Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Ava Saidian
- Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Ithaar H Derweesh
- Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USA
| |
Collapse
|