Reitano Giuseppe, Tumminello Arianna, Prevato Carlo, Cacco Anna, Gaggiato Greta, Baù Giorgia, Sabato Lorenzo, Tonet Elisa, Gambarotto Anna, Fusca Valerio, Martina Kevin, Visentin Silvia, Betto Giovanni, Novara Giacomo, Dal Moro Fabrizio, Zattoni Fabio
Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy.
Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy.
Cancers (Basel). 2025 Apr 20;17(8):1372. doi: 10.3390/cancers17081372.
The Da Vinci Single-Port (DV-SP) system emerged in 2018 but there is limited evidence on its use and perioperative outcomes for robot-assisted adrenalectomy (RAA).
A systematic search was performed through PubMed, Scopus, Ovid, and WoS in December 2024. A PICO framework was used.
adult patients with adrenal masses; Intervention: DV-SP RAA; Outcomes: feasibility, reproducibility and safety of DV-SP RAA. A total of five retrospective studies involving 342 patients were included. The quantitative analysis was conducted using a random-effect model or a fixed-effect model as appropriate. A risk of bias assessment for non-randomized comparative studies and case series was performed.
The pooled mean operative time was 92.5 min (95% confidence interval [CI] 71.2, 113.9, I = 0%, four studies), and the mean estimated blood loss (EBL) was 26.5 mL (95%CI -8.1, 61.2, I = 98.2%, three studies). Most of the procedures were completed with a single incision, though some required additional port placement, with a proportion of 9% (95%CI 0, 29, I = 71.7%, five studies). Perioperative complications were rare (0%, 95% CI 0, 4, I = 0%, five studies). Two studies comparing DV-SP and DV multi-port (MP) found no significant differences in complications. One study compared DV-SP RAA to DV Si or Xi single-access procedures. DV-SP showed improved operative techniques and better cosmetic outcomes. Limitations of this study are small sample size and potential selection bias due to smaller masses in the DV-SP RAA group.
DV-SP RAA is a promising approach, offering reduced operative time, low EBL, and excellent cosmetic results. This study shows that DV-SP RAA seems reproducible, feasible, and safe. Limitation of the included studies are small sample size and selection bias, which limits the generalizability of the results. Randomized comparative studies between DV-SP and MP RAA are needed to further validate these findings.
达芬奇单孔（DV-SP）系统于2018年问世，但关于其在机器人辅助肾上腺切除术（RAA）中的应用及围手术期结果的证据有限。
2024年12月通过PubMed、Scopus、Ovid和WoS进行了系统检索。采用了PICO框架。
成年肾上腺肿块患者；干预措施：DV-SP RAA；结果：DV-SP RAA的可行性、可重复性和安全性。共纳入5项涉及342例患者的回顾性研究。根据情况使用随机效应模型或固定效应模型进行定量分析。对非随机对照研究和病例系列进行了偏倚风险评估。
汇总平均手术时间为92.5分钟（95%置信区间[CI]71.2，113.9，I=0%，4项研究），平均估计失血量（EBL）为26.5毫升（95%CI -8.1，61.2，I=98.2%，3项研究）。大多数手术通过单一切口完成，不过有些需要额外放置端口，比例为9%（95%CI 0，29，I=71.7%，5项研究）。围手术期并发症罕见（0%，95%CI 0，4，I=0%，5项研究）。两项比较DV-SP和DV多孔（MP）的研究发现并发症无显著差异。一项研究将DV-SP RAA与DV Si或Xi单通道手术进行了比较。DV-SP显示出手术技术的改进和更好的美容效果。本研究的局限性在于样本量小以及DV-SP RAA组肿块较小可能存在的选择偏倚。
DV-SP RAA是一种有前景的方法，具有缩短手术时间、低EBL和出色的美容效果。本研究表明DV-SP RAA似乎具有可重复性、可行性和安全性。纳入研究的局限性在于样本量小和选择偏倚，这限制了结果的普遍性。需要进行DV-SP和MP RAA之间的随机对照研究以进一步验证这些发现。
