The safety and efficacy of single-port and multi-port robot-assisted partial nephrectomy (SP-RAPN and MP-RAPN, respectively) were assessed for treating partial nephrectomy in this study. A systematic review of PubMed, Cochrane Library, and Web of Science databases was conducted up to June 2024 to compare studies on SP-RAPN and MP-RAPN. Primary outcomes included perioperative results, complications, and oncological outcomes. Eight studies involving 1014 patients were analyzed. For binary outcomes, comparisons were performed using odds ratios (OR), and for continuous variables, weighted mean differences (WMD) with 95% confidence intervals (CI). The search failed to discover significant meaningful variations in operating times (p = 0.54), off-clamp procedure (P = 0.36), blood loss (p = 0.31), positive surgical margins (PSMs) (p = 0.78), or major complications (Clavien-Dindo grade ≥ 3) (p = 0.68) between SP-RAPN and MP-RAPN. However, shorter hospital stays (WMD - 0.26 days, 95% CI - 0.36 to - 0.15; p < 0.00001) and longer warm ischemia times (WIT) (WMD 3.13 min, 95% CI 0.81-5.46; p = 0.008) were related to SP-RAPN, and higher transfusion rate (OR 2.99, 95% CI 1.31-6.80; p = 0.009) compared to MP-RAPN. SP-RAPN performed better in terms of hospital stay but had slightly higher rates of transfusion, off-clamp procedures, and warm ischemia time (WIT) compared to MP-RAPN. As an emerging technology, preliminary research suggests that SP-RAPN is a feasible and safe method for carrying out a nephrectomy partial. However, compared to MP-RAPN, it shows inferior outcomes regarding (WIT) and transfusion rates.

UNASSIGNED: The purpose-built SHURUI single-port (SP) robotic platform has recently been introduced for several procedures in urology, general surgery, and gynecology. However, comparative evidence on its performance in relation to earlier models such as the da Vinci SP is lacking. Our aim was to compare the step-by-step techniques and 1-yr outcomes for radical prostatectomy (RP) between the SHURUI SP and da Vinci SP robots.
UNASSIGNED: Data were retrieved from two prospectively maintained databases. The SHURUI SP robot was used to perform RP in 34 patients in China (September 2021 to August 2022); the da Vinci SP robot was used to perform 100 consecutive RP cases in the USA (June 2019 to October 2020). A comparative analysis was conducted before and after 1:1 propensity score matching for age, body mass index, American Urological Association symptom score, prostate size, prostate-specific antigen (PSA) levels, biopsy grade group, and D\'Amico risk group. Intraoperative performance and short-term oncological and continence outcomes were compared between the groups. Biochemical recurrence was defined as two consecutive postoperative PSA levels >0.2 ng/ml. Continence was defined as full recovery of urinary control without the use of pads. The Kaplan-Meier method was used to estimate continence recovery curves, and a log-rank test for trend was used to detect ordered differences in continence recovery between the SHURUI SP and da Vinci SP groups after surgery.
UNASSIGNED: For the matched SHURUI and da Vinci groups, median age (69 vs 69 yr), median PSA (8.4 vs 7.1 ng/ml), and the proportion of patients with low-risk (33.3% vs 29.6%), intermediate-risk (66.7% vs 63%), and high-risk disease (0% vs 7.4%) were comparable (all p > 0.05). All surgeries were successfully accomplished without conversion. A higher percentage of cases in the SHURUI group involved extraperitoneal access (81.5% vs 0%; p < 0.001) and a pure SP approach (25.9% vs 0%; p = 0.01), while a higher percentage of cases in the da Vinci group had nerve-sparing surgery. The median total operative (215 vs 110 min; p < 0.001) and median console time (162 vs 75 min; p < 0.001) were significantly longer in the SHURUI group. No intraoperative or major postoperative complications were observed in either group. Rates of positive surgical margins (18.5% vs 14.8%; p = 1.0) and extraprostatic extension (14.8% vs 29.6%; p = 0.19) were similar. At median follow-up of 13.5 versus 15.9 mo, none of the patients had experienced biochemical recurrence. At 1 yr after surgery, the continence rate was 96.3% in both groups.
UNASSIGNED: Despite differences in driving mechanisms between the two SP robotic systems, RP can be performed safely and effectively with the SHURUI RP robot during the initial learning phase, with similar short-term oncological and continence outcomes to those with the da Vinci SP robot.
UNASSIGNED: We compared two surgical robots (SHURUI SP and da Vinci SP) used to perform robotic surgery to remove the prostate through a single keyhole incision instead of multiple incisions. Our results show comparable technology and similar surgical and short-term cancer control outcomes for the two robots.

BACKGROUND: The da Vinci Single-Port Robot System (DVSP) allows three robotic instruments and an articulated scope to be inserted through a single small incision. It received FDA approval in 2014 and was first introduced in 2018. The aim of this new system was to overcome the limitations of single-incision laparoscopic and robotic surgery. Since then, it has been approved for use only for urologic and transoral surgeries in some countries. It has been used as part of experimental protocols in general surgery.
OBJECTIVE: By obtaining the CE mark at the end of January 2024, DVSP will soon enter the European market. This review aims to comprehensively describe the applications of DVSP in general surgery.
METHODS: A search of PubMed, Embase, and Ebsco databases up to March 2024 was conducted, with registration in PROSPERO (CRD42024536430), following the preferred reporting items for Systematic reviews and Meta-analyses for scoping review (PRISMA-Scr) guidelines. All the studies about the use of DVSP in general surgery were included.
RESULTS: Fifty-six studies were included. The following surgical areas of use were identified: transabdominal and transanal colorectal, cholecystectomy, abdominal wall repair, upper gastroesophageal tract, liver, pancreas, breast, and thyroid surgery. The reported surgical and short-term outcomes are promising; a wide range of procedures have been performed safely. Some groups have found advantages, such as faster discharge, shorter operative time, and less postoperative pain compared to multiport robotic surgery.
CONCLUSIONS: Five years after its initial clinical applications, the use of the DVSP in general surgery procedures has demonstrated feasibility and safety. Hernia repair, cholecystectomy, and colorectal surgery emerge as the most frequently conducted interventions with this robotic system. Nevertheless, there is anticipation for further studies with larger sample sizes and extended follow-up periods to provide more comprehensive insights and data on the long-term outcomes, including the incidence of incisional hernia.

OBJECTIVE: A minimally invasive surgery (MIS) extraperitoneal (XP) approach to left-sided colorectal resection utilizing the laparoscopic approach has recently been shown to be safe and feasible and to have potential advantages over the transperitoneal approach, especially in high-risk surgical patients. The aim of this article is to provide a first cadaveric demonstration of the use of a single-port robotic platform in performing XP low anterior resection by MIS.
METHODS: A single-port robotic platform (DaVinci®SP™) was used to perform XP single-port low anterior resection in two cadavers with body mass indexes (BMIs) of 19 and 40 kg/m2.
RESULTS: The single-port robotic platform with versatile arms was successfully used to perform a complete low anterior resection with splenic flexure mobilization and total mesorectal excision through a single port.
CONCLUSIONS: A single-port robotic platform enhances complete XP dissection in the supine patient in extreme BMI ranges. Clinical studies are necessary to confirm these findings.

OBJECTIVE: To evaluate the different perioperative variables that may serve as important clinical predictors when selecting patients for outpatient single-port robot-assisted radical prostatectomy (SP-RARP).
METHODS: A retrospective review was performed on the Institutional Review Board-approved, prospectively maintained database to identify 485 consecutive patients who underwent SP-RARP between 2018 and 2023. A comparison analysis was performed on patients who were managed as outpatients vs inpatients following their respective SP-RARP. A separate analysis was performed after excluding patients with pre-planned admissions to identify the risk factors for unplanned admissions.
RESULTS: All procedures were successfully completed without any conversion or additional ports. After excluding patients with pre-planned admissions, outpatient SP-RARP was successfully achieved in 86.6% with a median (interquartile range) length of stay of 4.6 (3.8-6.1) hours. Our multivariate regression analysis identified cardiac comorbidity and preoperative International Prostate Symptom Score (IPSS) as predictors of outpatient SP-RARP. In addition, the absence of cardiac comorbidity, previous abdominal surgery, and lower postoperative pain score were protective against the risk of unplanned admission. Furthermore, both inpatient and outpatient encounters had comparable 90-day rates of postoperative complication (P = 0.136) and hospital re-admission (P = 0.942).
CONCLUSIONS: Outpatient management models could be successfully achieved in most patients who underwent SP-RARP (86.6%) while maintaining similarly low perioperative morbidity profile. Nevertheless, appropriate patient selection based on the baseline clinicodemographic characteristics remains essential to ensure the safety and ongoing success of outpatient SP-RARP.

BACKGROUND: Robotic surgery has emerged as a promising approach for managing complex hepatic malignancies. This report presents a case of a single-port robotic liver resection for a patient with recurrent hepatocellular carcinoma (HCC) and metastases, focusing on the surgical technique and outcomes.
METHODS: An 18-year-old female with a history of left hepatectomy for fibrolamellar HCC underwent robotic liver resection using the Da Vinci SP Surgical System. The procedure entailed excising a 30 mm tumor in liver segment 4 (Sg4) along with peritoneal metastases in the superior pole of the spleen and cardiophrenic lymph node metastasis. Surgical techniques comprised adhesiolysis, resection of the peritoneal nodule, Sg4 partial liver resection, and excision of the cardiophrenic lymph node.
RESULTS: The operative time was 310 min, with a blood loss of 37 mL. The patient experienced an uneventful postoperative course and was discharged home after 8 days. Partial liver resection of Sg4 revealed a moderately differentiated HCC with negative resection margins. Additionally, excision of peritoneal metastases in the superior pole of the spleen and cardiophrenic lymph nodes, consistent with metastasis, was performed. Notably, the Da Vinci SP system\'s relocation function proved useful in this case, particularly in slender patients with multiple distant metastases.
CONCLUSIONS: This case underscores the importance of technological advancements in robotic surgery. The Da Vinci SP system, with its advantageous features, shows promise in challenging clinical scenarios. Its ability to facilitate precise navigation and manipulation within the patient\'s restricted abdominal cavity contributed to the observed successful outcome.

UNASSIGNED: With the introduction of the da Vinci single-port (SP) robot platform, surgery in a narrow space has become easier, and using this, extraperitoneal radical prostatectomy has been frequently performed recently. However, studies comparing it with existing methods are still lacking. Therefore, in this study, we compared the initial extraperitoneal single-port robot-assisted radical prostatectomy (spRARP) with intraperitoneal multiport robot-assisted radical prostatectomy (mpRARP) and tried to investigate the feasibility of extraperitoneal spRARP.
UNASSIGNED: We retrospectively analyzed patients who underwent RARP performed between January 2019 and April 2023. A total of 184 consecutive patients were enrolled in this study: 64 underwent spRARP and 120 underwent mpRARP. Patient characteristics before and after surgery were investigated, and period of passing gas, foley maintenance period, length of hospital stay, and pain changes were compared and analyzed to estimate post-surgery recovery. To address inherent biases stemming from differing patient characteristics at baseline, we performed an additional analysis after propensity score matching (PSM) (ratio, 1:1).
UNASSIGNED: After PSM, both the spRARP and mpRARP groups consisted of 64 patients each. On preoperative examination, there were no significant differences in prostate-specific antigen level, Gleason score (GS), prostate volume, magnetic resonance imaging T stage, or Prostate Imaging-Reporting and Data System score between the two groups. Following surgery, there were no significant differences in operative and console time between the two groups. Notably, the estimated blood loss was considerably lesser in the spRARP group than in the mpRARP group (P=0.049). When comparing pathologic outcomes, the GS, T stage, positive surgical margin, extracapsular extension, and seminal vesicle invasion rates showed no significant differences between the two groups. Four patients who underwent spRARP and six who underwent mpRARP suffered Clavien-Dindo classification grade 3 and 4 complications. After 3 months, there were no significant differences in incontinence or potency between the two groups. However, even after PSM, the period of passing gas was earlier in the spRARP group than in the mpRARP group.
UNASSIGNED: In this study, both the extraperitoneal spRARP and transperitoneal mpRARP groups exhibited similar complication rates and surgical outcomes. Furthermore, the spRARP group had a short surgical time and demonstrated early recovery. Therefore, extraperitoneal spRARP is a feasible procedure that is expected to become increasingly popular in the future.

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