Single-Port Robotic Posterior Retroperitoneoscopic Adrenalectomy (SPRe-Ad): A GelPOINT Mini-Enabled Floating-Docking Technique
Marco Raffaelli, Priscilla Francesca Procopio, Antonio Laurino, Pierpaolo Gallucci, Carmela De Crea, Francesco PennestrìPurpose:
To describe a GelPOINT Mini–enabled access configuration for single-port posterior retroperitoneoscopic adrenalectomy (SPRe-Ad) using the da Vinci SP system, with emphasis on floating docking, posterior abdominal-wall tenting, and early perioperative outcomes.
Materials and Methods:
Two consecutive adults underwent unilateral SPRe-Ad through a 3-cm posterior incision. The GelPOINT Mini accommodated the SP cannula and a 12-mm assistant trocar through the same GelSeal cap. Aggregate perioperative data from 32 multiport robotic PRA procedures performed within the same institutional program were reviewed as a descriptive benchmark; no inferential comparison was undertaken.
Results:
The cases involved a 17-mm left pheochromocytoma and a 9-mm right aldosterone-producing adenoma. Docking, console, and total operative times were 4, 40, and 71 minutes and 6, 50, and 83 minutes, respectively. In the multiport cohort, corresponding median times were 6.0 (IQR, 4.3–7.8), 18.0 (12.3–22.8), and 57.5 (45.3–74.3) minutes. Neither SPRe-Ad case required conversion or developed intraoperative or 30-day postoperative complications, and hospital stay was 2 days in both patients.
Conclusion:
GelPOINT Mini-enabled floating docking provided single-incision assistant access and mechanical posterior abdominal-wall tenting during da Vinci SPRe-Ad. These first two cases support technical applicability within an established robotic PRA program; prospective comparative studies should determine whether this configuration increases operative workspace, reduces insufflation-pressure requirements, or improves operative efficiency and clinical outcomes.