Introduction: Renal autotransplant has been done historically with an open approach. With the advent of the single port robot (SP), this procedure can be done in a minimally invasive manner to potentially improve peri-operative morbidity and the patient experience. The purpose of this study is to compare this novel SP approach with the standard open approach. Methods: We retrospectively assessed patients who have undergone SP autotransplant from 2020-2021 with matched patients who underwent open autotransplant from 2006-2019 at a single institution who did not undergo additional operative interventions during the index surgical admission. We performed descriptive analyses on patient characteristics, postoperative complications and readmissions with chi-square and t-test analyses. Results: Nine patients underwent SP autotransplant and were matched to 26 patients in the open approach. In the matched SP and open groups, average ages were 41 (SD 11) and 42 (SD 9) years respectively (p = 0.72), and 8 (31%) were male in the open and 3 (30%) in the SP group (p = 0.89). Nephrolithiasis history was present in 18 (69%) patients in the open and 8 (89%) in the SP group (p = 0.25). A majority of patients had history of percutaneous nephrostomy tube or ureteral stent – 20 (77%) in the open and 9 (100%) in the SP groups (p = 0.11). Nineteen (73%) in the open and 9 (100%) in the SP groups had ureteral stent placement intraoperatively (p = 0.08). In Table 1, there were no significant differences between the open and SP groups regarding operative time (533 vs. 539 minutes, p = 0.92), postoperative creatinine (0.98 vs. 0.96, p = 0.87), or postoperative complications (14 (54%) vs. 2 (22%), p = 0.10), which included bleeding requiring transfusion. Significant differences between open and SP approaches were estimated blood loss (EBL) (910 vs. 147 milliliters, p = 0.006), post- and intraoperative bleeding prompting transfusion (13 (50%) vs. 0 (0%), p = 0.007), and length of stay (8 vs. 5 days, p = 0.006). Conclusions: In this novel approach, SP renal autotransplant demonstrates lower EBL, bleeding complications, length of stay, and postoperative complications, compared to the traditional open approach. Additional studies are warranted to determine if a minimally invasive approach can improve patient outcomes longitudinally. SOURCE OF Funding: None
