Comparison of Single-Port Robotic Donor Nephrectomy and Laparoscopic Donor Nephrectomy

摘要

Purpose: To compare the intra-operative and post-operative outcomes of Single-Port Robotic Donor Nephrectomies (SP RDNs) and Laparoscopic Donor Nephrectomies (LDNs) Materials and Methods: We retrospectively reviewed our institutional database for patients who received LDN or SP RDN between September 2020 and December 2022. Donor baseline characteristics, intra-operative outcomes, post-operative outcomes, and recipient renal function were extracted and compared between LDN and SP RDN. SP RDN learning curve analysis based on operative time and graft extraction time was performed using Cumulative Sum Analysis. Results: 144 patients underwent LDN and 32 patients underwent SP RDN. LDN and SP RDN had similar operative times (LDN: 190.3 ± 28.0 min., SP RDN: 194.5 ± 35.1 min., p=0.3253). SP RDN patients had significantly greater extraction times (LDN: 83.2 ± 40.3 sec., SP RDN: 204.1 ± 52.2 sec, p<0.0001) and warm ischemia times (LDN: 145.1 ± 61.7 sec., SP RDN: 275.4 ± 65.6 sec., p<0.0001). There were no differences in patient subjective pain scores, inpatient opioid usage, or Clavien-Dindo II+ complications. Short- and medium-term post-operative donor and recipient renal function were also similar between the groups. SP RDN graft extraction time and total operative time learning curves were achieved at case 27 and 13, respectively. Conclusion: SP RDN is a safe and feasible alternative to LDN that minimizes post-operative abdominal incisional scars and has a short learning curve. Future randomized prospective clinical trials are needed to confirm the findings of this study and to identify other potential benefits and drawbacks of SP RDNs.