Single-port Mini-Pfannenstiel Robotic Pyeloplasty: Establishing a Non-narcotic Pathway Along With a Same-day Discharge Protocol

Beksaç, Alp Tuna; Wilson, Clark A.; Lenfant, Louis; Kim, Soo Dong; Aminsharifi, Ali; Zeinab, Mahmoud Abou; Kaouk, Jihad

doi:10.1016/j.urology.2021.10.013

Cited by 12 publications

(18 citation statements)

References 22 publications

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“…Not surprisingly, an extremely low EBL was consistently observed in this series, irrespective of the chosen surgical approach for the RAP. Indeed, our results are supported by findings from a previous study, pointing out the similarity between the two techniques in terms of EBL, 9,10,17 and therefore, underscoring the safety of this procedure.…”

Section: Discussionsupporting

confidence: 90%

“…Therefore, the decision regarding the length of hospital stay is left to the surgeon's preference. Nevertheless, a significantly reduced LOS in patients undergoing SP RAP (12.18 h) compared to MP RAP (42.66 h, p < 0.001) was previously reported by Beksac et al 9 and further confirmed by Gu et al. in their meta‐analysis 17 .…”

Section: Discussionsupporting

confidence: 68%

“…Bekcsac et al. reported an OT of 159 min, showing no significant difference compared to MP approach 9 . Conversely, Harrison et al.…”

Section: Discussionmentioning

confidence: 96%

“…Different incision sites for SP RAP have been documented in the literature, all of which have shown satisfactory outcomes. 9 After an umbilical incision, the scar remains completely concealed within the umbilicus after healing, resulting in favourable cosmetic results (Figure 1D). Based on our experience, this has led to high levels of patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, Beksac et al. proposed a non‐narcotic protocol for SP RAP, showing a significant reduction in MME and opioid at discharge 9 . On the contrary, Harrison et al.…”

Section: Discussionmentioning

confidence: 99%

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Single port robot‐assisted pyeloplasty: An early comparative outcomes analysis

Ditonno,

Franco,

Manfredi

et al. 2024

Robotics Computer Surgery

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BackgroundThe treatment paradigm for ureteropelvic junction obstruction (UPJO) has shifted towards minimally invasive pyeloplasty. A comparison Single Port (SP) and Multi Port (MP) robot‐assisted pyeloplasty (RAP) was performed.MethodsData from consecutive patients undergoing SP RAP or MP RAP between January 2021 and September 2023 were collected and analysed. Co‐primary outcomes were length of stay (LOS), Defense and Veterans Pain Rating Scale (DVPRS), and narcotic dose. The choice of the robotic system depended on the surgeon's preference and availability of a specific robotic platform.ResultsA total of 10 SP RAPs and 12 MP RAPs were identified. SP RAP patients were significantly younger [23 years (20–34)] than MP RAP [42 years (35.5–47.5), p < 0.01]. No difference in terms of OT (p = 0.6), LOS (p = 0.1), DVPRS (p = 0.2) and narcotic dose (p = 0.1) between the two groups was observed.ConclusionsSP RAP can be implemented without compromising surgical outcomes and potentially offering some clinical advantages.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 68%

“…Bekcsac et al. reported an OT of 159 min, showing no significant difference compared to MP approach 9 . Conversely, Harrison et al.…”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

“…Moreover, Beksac et al. proposed a non‐narcotic protocol for SP RAP, showing a significant reduction in MME and opioid at discharge 9 . On the contrary, Harrison et al.…”

Section: Discussionmentioning

confidence: 99%

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Single port robot‐assisted pyeloplasty: An early comparative outcomes analysis

Ditonno,

Franco,

Manfredi

et al. 2024

Robotics Computer Surgery

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Robot-Assisted Pyeloplasty

Sanekommu,

Hughes,

Thomas

2024

Robotic Urology

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Low anterolateral incision for single-port extraperitoneal robot-assisted pyeloplasty: description of technique and initial experience

Ramos,

Chavali,

Ferguson

et al. 2024

World J Urol

Self Cite

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Purpose This study aims to describe the surgical steps for the single-port low anterolateral extraperitoneal approach to pyeloplasty, report its feasibility, and share the initial outcomes of our experience. Methods We analyzed all consecutive patients who underwent single-port low anterolateral extraperitoneal pyeloplasty due to ureteropelvic junction obstruction (UPJO). The surgical steps included a pure single-port approach through a 3.5 cm low anterolateral incision two fingerbreadths above the superior pubic ramus. The ureter was localized and followed cranially, a dismembered pyeloplasty was performed, and a running ureteropelvic anastomosis was completed. No drains were placed. The urinary catheter was removed upon discharge, and the ureteral stent after 3–5 weeks. Results A total of eight cases (two adults and six children) were completed successfully, without complications or conversions. Median operative time, console time, and estimated blood loss were 208.5 min, 114.5 min, and 10.0 ml, respectively. All patients were discharged within 24 h, except for one that required urinary output observation due to retention. There were no major postoperative complications. The median pain score at discharge was 0/10. Only one patient was prescribed PRN opioids at discharge. The readmission rate was 0.0%. All patients were asymptomatic on their last follow-up with no definitive obstruction on imaging, and no requirement for additional procedures or stents. Conclusion Single-port low anterolateral extraperitoneal pyeloplasty is a feasible alternative for surgical treatment of UPJO in adult and pediatric patients with improved recovery outcomes.

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Single-port Mini-Pfannenstiel Robotic Pyeloplasty: Establishing a Non-narcotic Pathway Along With a Same-day Discharge Protocol

Cited by 12 publications

References 22 publications

Single port robot‐assisted pyeloplasty: An early comparative outcomes analysis

Single port robot‐assisted pyeloplasty: An early comparative outcomes analysis

Robot-Assisted Pyeloplasty

Low anterolateral incision for single-port extraperitoneal robot-assisted pyeloplasty: description of technique and initial experience

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