Transperitoneal versus retroperitoneal single port robotic nephroureterectomy: Multi-institutional comparison analysis from the Single Port Advanced Research Consortium (SPARC)
Recommended Citation
Lavagno F, Soputro NA, Fankhauser C, Contieri R, Ingrassano S, Deghanmanshadi A, Considine J, Moran M, Kaufman E, Sauer-Calvo R, Daher K, Zhu A, Nix JW, Mehrazin R, Ghodoussipour S, Abdollah F, Rogers C, Silvani C, Santangelo A, Perdona S, Elsamra S, Rais-Bahrami S, Kaouk J, Mattei A, Crivellaro S, Autorino R, Gontero P. Transperitoneal versus retroperitoneal single port robotic nephroureterectomy: Multi-institutional comparison analysis from the Single Port Advanced Research Consortium (SPARC). Eur Urol 2026; 89:1.
Document Type
Conference Proceeding
Publication Date
3-1-2026
Publication Title
Eur Urol
Keywords
Urology & Nephrology
Abstract
Introduction & Objectives: To compare the perioperative, oncological, and renal function outcomes of Single Port (SP) robotic nephroureterectomy (RNU) performed via retroperitoneal (RP) and transperitoneal (TP) approaches. Materials & Methods: A retrospective review was conducted using the IRB-approved multi-institutional database of the Single Port Advanced Research Consortium (SPARC) to identify all consecutive SP-RNU cases performed between 2018 and 2025. Procedures were categorized by surgical approach as either RP or TP. Baseline clinicodemographic, intraoperative, and postoperative outcomes were collected, with inferential statistics as presented. Trifecta outcomes were defined as the occurrence of bladder cuff excision, negative surgical margins, and no major complications. Results: Among 125 SP-RNU cases, 100 (80%) and 25 (25%) were performed via an RP and TP approaches, respectively. The two cohorts demonstrated comparable baseline characteristics. All procedures were completed successfully, with supine positioning more commonly used in RP SP-RNU (61% vs. 0%, p<0.001). Robotic bladder cuff excision was performed in 87.2% of RP and 100% of the TP cases (p=0.998), while lymph node dissections were pursued in 47.1% of RP and 47.4% of TP SP-RNU (p=0.474). Rates of positive margins (7.5% vs. 5.3%, p=0.997) and median renal function preservation at discharge (median, 85.8% vs. 91.9%, p=0.427) were found to be similar between groups. Although not reaching statistical significance, postoperative complications were less frequent in the RP cohort. (20.8% vs. 28.6%, p=0.219). Trifecta outcomes were reported following 62.2% of the RP and 68% of the TP techniques (p=0.776). At a median follow-up of 6 months, recurrence-free survival remained similar at 81% and 74.9% for the RP and TP SP-RNU, respectively (p=0.511). Conclusions: SP-RNU can be effectively completed using either RP and TP approaches, with similarly favorable perioperative, renal function, and oncological outcomes. While the SP RP approach demonstrated a trend towards reduced postoperative morbidity, larger cohort analysis remains necessary to evaluate its perioperative benefits, especially when compared to other minimally invasive surgical techniques.
Volume
89
First Page
1
