Implementation and early outcomes of Da Vinci SP® Robot-Assisted partial nephrectomy via supine anterior retroperitoneal access: Italian single centre experience

Abstract

Introduction: The da Vinci SP® Surgical System, approved by the FDA in 2018 for urological procedures and by the European Union in 2024, is now being adopted across Europe. This report presents the first Italian experience with single-port robot-assisted partial nephrectomy (RAPN) using the SP system. Material and methods: From May 8 and May 31, 2024, ten consecutive male patients underwent single-port RAPN via a Lower Anterior retroperitoneal Access (LAA) at a single institution. Perioperative and early postoperative variables were prospectively collected and analyzed. Results: (IQR 24.9-34), and median Charlson Comorbidity Index was 5 (IQR 4-6). Sixty percent had an ASA score of 3. Median RENAL and PADUA scores were 8 (IQR 7-9) and 7 (IQR 7-8), respectively. Tumours were <4 cm. Median warm ischaemia time was 21.5 minutes (IQR 15.25-26.5), operative time was 120 minutes (IQR 100-180), and blood loss was 60 ml (IQR 50-80). Pre- and postoperative eGFR medians were 84.9 and 84.2, respectively. Patients were discharged on postoperative day one with a median pain score of 1.3/10. No major (Clavien-Dindo ≥ III) complications occurred. One patient had a positive surgical margin. Conclusions: Single-port RAPN with the da Vinci SP® system is safe and feasible, with promising short-term outcomes.