Single-port robotic system - a paradigm shift in robot-assisted radical prostatectomy?

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Robotic-assisted radical prostatectomy (RARP) is a standard treatment for prostate cancer.
• Advancements in minimally invasive surgical systems are crucial for improving patient outcomes.
• The Da Vinci single-port (SP) system represents a new frontier in robotic surgery.

Purpose of the Study:

• To evaluate the potential and clinical utility of the Da Vinci SP system in RARP.
• To compare the technical innovations and clinical benefits of the SP system against multi-port (MP) systems.
• To identify challenges and future research directions for SP RARP.

Main Methods:

• A narrative review of studies published between January 2018 and February 2025.
• Searches were conducted on PubMed and Scopus databases.
• Prioritization of studies comparing SP and MP systems for RARP.

Main Results:

• The Da Vinci SP system offers 360° visualization, integrated instruments, and enhanced depth perception.
• Clinical benefits include reduced blood loss, faster recovery, improved cosmesis, and less surgical trauma.
• Oncological and functional outcomes with SP are comparable to MP, though a steeper learning curve exists.

Conclusions:

• The SP system shows promise for enhancing patient care in RARP due to its minimally invasive nature.
• It achieves comparable outcomes to MP systems while uniquely minimizing surgical trauma.
• Overcoming technical challenges and the learning curve is essential for widespread adoption; further research on long-term impact is needed.