#1187
Impact of AirSeal® on peri-operative outcomes in robotic-assisted partial nephrectomy: a retrospective comparative study
J. Hoe1, D. Teo1, E. Htoo2, K. Ng1, P. Durai3, J. Lu2, Y. Goh2, H. Tiong2
1Yong
Loo Lin School of Medicine, National University of Singapore, Singapore,
Singapore
2National University Hospital, Urology, Singapore, Singapore
3Ng Teng Fong General Hospital, Urology, Singapore, Singapore
Introduction:
The AirSeal® system (AS) is an insufflation system designed to improve perioperative outcomes by maintaining stable pneumoperitoneum and valve-free access to the abdomen. This study compares the clinical impact of AS and conventional insufflation (CI) in robotic-assisted partial nephrectomy (RAPN).
Material and methods:
This retrospective study reviewed 87 patients (Male N=59(68%), Mean age 56.3±12years) who consecutively underwent RAPN from Jan 2022 to Mar 2024 at the National University Hospital, Singapore. Patients were divided into AS (N=55(63%)) and CI group (N=32(37%)). RAPN was performed with warm ischemia, using a pneumoperitoneum maintained at <15mmHg. Use of AS or CI was based on surgeon preference. Baseline demographics, clinical parameters and perioperative outcomes were compared between the groups.
Results:
No significant differences (p>0.05) were found between AS and CI group respectively for mean age (55±12 vs 58±12years), male gender (N=35(64%) vs 24(75%)), Chinese race (N=41(75%) vs 25(78%)), median BMI (25.2 vs 26.0) and ASA≤2 proportion (N=46(84%) vs 27(84%)). Complexity of RAPN in terms of median tumour size (2.5 vs 2.6cm), median RENAL score (7 vs 8), multiple arteries cases (N=8(15%) vs 9(28%)) were similar (p=NS). Retroperitoneal and arterial-only (AO) clamping approaches were utilized in 10 (18%) and 48 (87%) patients in AS group respectively. This was significantly higher than the corresponding 0(0%), p<0.05 and 16(50%), p<0.01 in CI group. AS group had significantly lower estimated blood loss (50(IQR 20-150) vs 100(IQR 50-200)ml, p<0.01) than CI group, which required 1 blood transfusion. Mean operative time (268.7±53.4 vs 263.7±46.8min) and complication rates (N=0 vs 2) were similar. Surgical margin involvement was proportionally lower in AS group (N=3(6%) vs 4(13%), p=0.42).