Single-Port vs Multiport Robotic Surgery in Urologic Oncology: A Narrative Review

Area of Science:

• Urologic Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic surgery enhances visualization and maneuverability in urologic oncology.
• The daVinci single-port (SP) platform offers potential advantages like improved cosmesis and reduced pain over multiport (MP) systems.
• Comparisons between SP and MP robotic surgeries are limited by small, non-randomized studies.

Purpose of the Study:

• To review and compare oncologic and functional outcomes of SP versus MP robotic surgery for prostate, kidney, and bladder cancer.

Main Methods:

• A literature review of PubMed was conducted for studies comparing SP and MP robotic surgeries for prostatectomy, nephrectomy, and cystectomy from 2018 to 2024.
• English-language studies were included; non-oncologic indications were excluded.

Main Results:

• No significant differences in margin status or recurrence were found between SP and MP robotic surgeries for radical prostatectomy, partial nephrectomy, or radical cystectomy.
• Operative time, blood loss, and complication rates were similar between SP and MP platforms.
• SP surgery may offer advantages in reduced hospital stay, pain, and improved incision satisfaction, though not consistently demonstrated. Functional outcomes were comparable.

Conclusions:

• The daVinci SP platform is a safe and effective tool for urologic oncologic procedures, with outcomes comparable to MP robotic surgery.
• Current evidence does not definitively prove superior oncologic or functional outcomes for SP over MP surgery.
• Theoretical benefits of SP surgery include improved hospital stay and cosmesis.