Open Access

HOW I DO IT

Single port robotic partial nephrectomy via a retroperitoneal approach

Joon Yau Leong^1,*, Vignesh Prasad², Carlos J. Perez Kerkvliet¹, Andrew A. Wagner³, Richard E. Link⁴, Mihir S. Shah¹

1 Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
2 Drexel University College of Medicine, Philadelphia, PA 19104, USA
3Division of Urology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
4 Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA

* Corresponding Author: Joon Yau Leong. Email:

Canadian Journal of Urology 2025, 32(5), 469-475. https://doi.org/10.32604/cju.2025.066348

Received 06 April 2025; Accepted 18 August 2025; Issue published 30 October 2025

Abstract

In recent years, the introduction of the Da Vinci Single Port (SP) robotic platform has opened new doors for the treatment of localized renal masses. This technology, particularly when utilized via a regionalized retroperitoneal (RP) approach, offers several distinct advantages that may improve patient recovery. These advantages include easier access to both anterior and posterior renal tumors, avoidance of the peritoneal cavity with complicating adhesions, and simplified supine positioning, potentially reducing the risk of musculoskeletal or nerve injuries. Yet, the learning curve for RP surgery remains steep due to the unfamiliarity of many surgeons with the RP endoscopic perspective and ergonomic challenges of the SP robot. Given this relatively new technology and its growing availability in many institutions, most surgeons remain early in their evolution of performing SP partial nephrectomy (PN). Herein, we discuss our technique for performing SP PN via an RP approach, including port access, anatomic considerations, and operative techniques. Our hope is to familiarize readers with this powerful approach and smooth out early pitfalls during the learning curve.

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Keywords

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