title: Two-port robot-assisted vs standard robot-assisted laparoscopic partial nephrectomy: a matched-pair comparison.
abstract: OBJECTIVE
  To compare the outcomes between 2-port robot-assisted partial nephrectomy (2-portRALPN) and standard robot-assisted laparoscopic partial nephrectomy (sRALPN).
  
  
  METHODS
  From May 2009 to February 2010, 35 2-portRALPN were done by a single surgeon in a university-based tertiary referral center. A cohort of 35 patients who underwent sRALPN from September 2006 to July 2009 was selected for retrospective comparison and matched for tumor complexity. All patients underwent partial nephrectomy (PN) using the daVinci surgical robotic platform (Intuitive Surgical, Sunnyvale, CA). In the 2-portRALPN, a homemade umbilical port and an infraumbilical assistant port were used, whereas standard laparoscopic port placement was used for sRALPN. The clinical, operative, pathologic, and follow-up information were collected.
  
  
  RESULTS
  The operative time (187.5 vs 171.7 minutes, P=.110), warm ischemia time (29.5 vs 28.8 minutes, P=.209), blood loss (257 vs 242.5 mL, P=.967), complication rate (17.1 vs 11.4%, P=.495), and transfusion rate (8.6 vs 2.9%, P=.303) were comparable in both groups. The pain scores on the first postoperative day (4.5 vs 3.9, P=.236) and on the day of discharge (2.3 vs 1.9, P=.433), in-hospital morphine requirement (130.5 vs 122.2 mg, P=.115), and length of hospital stay (4.2 vs 4.2 days, P=.875) were likewise similar in both groups.
  
  
  CONCLUSIONS
  This matched-pair study design comparing 2-portRALPN with sRALPN shows that the outcomes of both techniques are comparable. The 2-portRALPN technique is a viable option until a more advanced robotic platform specifically designed for laparoendoscopic single-site surgery is developed and a pure robot-assisted laparoendoscopic single site surgery PN can be safely performed.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Francis Raymond P
authors.initials: FR
authors.lastname: Arkoncel
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Woong Kyu
authors.initials: WK
authors.lastname: Han
authors.forename: Ha Bum
authors.initials: HB
authors.lastname: Jeoung
authors.forename: Cheol Kyu
authors.initials: CK
authors.lastname: Oh
mesh_terms: D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000295:instrumentation; D007902:Length of Stay; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D012371:Robotics / Q000295:instrumentation