Robotic partial nephrectomy (RPN) is a standard-of-care nephron-sparing intervention for clinical stage T1 renal masses (cT1RMs). We evaluated RPN outcomes performed using the da Vinci single port (SP) and multiport (Xi) platforms in a statewide quality improvement collaborative since SP introduction in Michigan. MUSIC-KIDNEY maintains a prospective registry of newly diagnosed cT1RM. Six surgeons from three practices within MUSIC have performed both. The perioperative data from patients undergoing SP and Xi RPN with these surgeons October 2020-August 2023 were analyzed. These surgeons completed a survey to assess reasons for choosing SP over Xi RPN. Of 828 RPNs performed by all MUSIC surgeons in the same duration, a total of 314 (38%) RPNs were completed by the six included surgeons who performed 121 (39%) RPNs with SP and 193 (61%) with Xi. SP RPN more commonly utilized the retroperitoneal approach than Xi RPN (80% vs. 6.1%, p < 0.001). When comparing perioperative outcomes, the experienced SP surgeon utilized same-day (55% vs. 9.5% vs. 5.7%, p < 0.001) and opioid-free discharge (77% vs. 22% vs. 18%, p < 0.001) significantly more than other urologists for both SP and Xi cases without a significant increase in positive surgical margins, ED visits, or readmissions. The survey results showed that surgeons early in the learning curve for SP RPN prefer to use SP for smaller, less complex masses. Although there has been limited adoption of SP RPN, initial experiences with SP RPN demonstrate procedural safety comparable to Xi RPN. Both robotic systems provide advantages, with SP mainly facilitating the retroperitoneal approach.
Journal of robotic surgery. 2025 Aug 30*** epublish ***
Yuzhi Wang, Jerry Zhuo, Bradley Christensen, Kangli Chen, Stephanie Daignault-Newton, Banna Hussain, Mackenzie Gammons, Mustafa Almajedi, Savannah Grandy, Adam Matynowski, Sabrina L Noyes, Mahin Mirza, Sugandh Shetty, Syed Mohammed A Jafri, Conrad Tobert, Christopher Brede, Craig G Rogers, Brian R Lane, Ryan Nelson, Michigan Urological Surgery Improvement Collaborative (MUSIC)
Vattikuti Urology Institute, Henry Ford Health, Detroit, MI, USA., Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA., Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA., Department of Urology, McLaren Macomb, Mt. Clemens, MI, USA., Corewell Health Hospital System, Grand Rapids, MI, USA., Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA., Michigan Institute of Urology, 11051 Hall Road, Suite 220 , Utica, MI, 48317, USA. .