First report of transumbilical robotic-assisted single-port laparoscopic partial nephrectomy using a domestic Shurui® robotic system: a report of two cases

Background: robotic system, aiming to evaluate the feasibility, safety, and early outcomes of this novel surgical approach. Case Description: Two patients (a 65-year-old woman and a 56-year-old man) with SRMs underwent transumbilical SP-RAPN via a 3 cm peri-umbilical incision within the natural skin crease. The RENAL (radius, exophytic, nearness, anterior/posterior, and location) nephrometry scores of these two cases were 5 and 6. Intraoperative data, including docking time, operative duration, estimated blood loss (EBL), warm ischemia time (WIT), and postoperative pain scores, were prospectively recorded. Both procedures were successfully completed without conversion to open or multi-port surgery. Docking time was 4 minutes in both cases; console time was 112 and 135 minutes; EBL was 100 and 50 mL; WIT was 24 and 21 minutes; and postoperative length of stay was 5 and 6 days, respectively. No Clavien-Dindo grade ≥ II complications occurred. Postoperative pain intensity assessed with the numeric rating scale (NRS) was ≤2/10 at 24 hours and decreased to 0-1/10 by postoperative day 2. Pathological report of renal clear cell carcinoma [World Health Organization (WHO) grade 2], with negative margins in both cases. Conclusions: robotic system is technically feasible, and associated with favorable perioperative outcomes, minimal postoperative pain, satisfactory cosmetic results, and adequate safety profile, while short-term oncological and functional outcomes appear acceptable.