Feasibility of aesthetic port placement in robot-assisted pyeloplasty a single institute study in all age groups.

This study aimed to identify patient factors associated with aesthetic port placement in robot-assisted pyeloplasty (RAPP) at a single institute treating all age groups. Patients who underwent multiport da Vinci RAPP between 2015 and 2023 were retrospectively reviewed. Port placement was determined based on the location of the ureteropelvic junction. The non-visible port position was defined as that placed in the umbilicus or below the bikini line. Demographic data were compared between the aesthetic (zero or only one visible port scar) and non-aesthetic (two or more visible port scars) port placement groups. Receiver operating characteristic (ROC) curve analysis and multivariable logistic regression were performed to assess the determinants of aesthetic placement. Forty-five patients were included (18 males and 27 females; age: 2–69, median 23 years). Sixteen of the 17 patients (94%) aged ≤ 15 years and 14/28 (50%) aged > 15 years achieved aesthetic port placement. Compared with the non-aesthetic port placement group, the aesthetic port placement group was significantly younger, shorter, and had a lower body mass index (all p < 0.05). Independent determinant for aesthetic port placement was body mass index (OR = 0.40, 95% CI: 0.18–0.66, p = 0.004) and age (OR = 0.93, 95% CI: 0.86–0.98, p = 0.025). ROC analysis identified body mass index as the strongest predictor (area under the curve = 0.931, cutoff = 20.6). These findings provide a basis for preoperative port planning and instructions for patients who are concerned for wound cosmesis.