Presented by: Sarah Brink MD
Hackensack University Medical Center

Introduction

The Single Port (SP) robot is a new technology utilized in urologic surgery. Extrapolating from single-site laparoscopy data, there is concern regarding increased incisional complications given the size of the incision. This study seeks to evaluate SP incisional complications for renal, genitourinary reconstruction, bladder, and prostate surgeries.

Materials

IRB-approved prospective databases were used to identify cases of SP robotic surgery from 2019 to 2022. All cases included had documentation of incision location and a minimum of 3-month follow-up. Postoperative outcomes included incisional hernia, wound infection, and/or wound dehiscence. Subgroup analysis was performed by incision location.

Results

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295 cases were analyzed. There were only 6 incisional complications (6/295, 2.0%), with 4 herniae, 2 wound infections, and 0 wound dehiscences. Among the 4 herniae, the highest incidence occurred via lower quadrant transperitoneal incision (4.2%, 1/24), followed by umbilical transperitoneal incision (3.4%, 2/58), and finally by infraumbilical extraperitoneal incision (0.6%, 1/180). There were no herniae via mid-axillary or Pfannenstiel incisions. The transperitoneal (1/84, 1.2%) and extraperitoneal (1/211, 0.5%) groups had 1 wound infection each. Overall, the transperitoneal incisions accounted for a 4.8% (4/84) incidence of complications (3 herniae and 1 infection) versus the extraperitoneal incisions, which accounted for a 0.9% (2/211) incidence of complications (1 hernia and 1 infection).

Conclusion

To our knowledge, this represents the first descriptive study of SP incisional complications. Incisions that utilize an extraperitoneal approach have very low risk of hernia or infection. When using a transperitoneal approach, both the umbilical and lower quadrant incisions have low risk of hernia. Larger numbers and comparison data to multiport robotic surgery will help to elucidate the significance of our SP findings. 

Funding

None.

Co-Authors

Nathan Cheng, MD
Hackensack University Medical Center

Jennifer Nguyen, BS
Hackensack University Medical Center

Teona Iarajuli, BS
Hackensack Meridian School of Medicine

Katherine Kim, BS, MBS
Hackensack Meridian School of Medicine

Meghana Singh, BA
Hackensack Meridian School of Medicine

Angelo Cadiente, BS
Hackensack Meridian School of Medicine

Andre Ho, BS
Hackensack Meridian School of Medicine

Ruchir Chaturvedi, BS
Hackensack Meridian School of Medicine

Catherine Implicito, BS
Hackensack Meridian School of Medicine

Gregory Lovallo, MD
Hackensack University Medical Center

Mutahar Ahmed, MD
Hackensack University Medical Center

Michael Stifelman, MD
Hackensack University Medical Center