Da Vinci Single-Port Robotic Surgery in Europe: Where Do We Stand? A Systematic Review

Background/Objectives: The da Vinci Single-Port (SP) system represents a recent evolution in robotic-assisted surgery, offering enhanced articulation and access through a single incision. The SP system was approved by the European Medicine Agency (EMA) in January 2024. Methods: This review synthesizes current clinical evidence on the feasibility, safety, and versatility of SP-assisted procedures across multiple surgical specialties to date based on a comprehensive literature search conducted through major databases (MEDLINE, EMBASE, and Cochrane) according to PRISMA and PICOS guidelines. Results: A total of 14 studies were included, highlighting that the SP platform has been successfully adopted in complex procedures such as cervical esophagectomy, radical prostatectomy, nephrectomy, gynecologic procedures, and wall surgery. Across indications, the SP approach is associated with reduced blood loss, shorter hospital stays, and low complication rates. On the other hand, limitations include restricted working space and the steep learning curve. Conclusions: Overall, the da Vinci SP platform expands the scope of minimally invasive surgery, but European centers lag behind international trends, particularly when compared to new, less-invasive techniques adopted in high-volume SP centers in the US. Urology remains the main field of application.