Single-port robotic partial nephrectomy with the Da Vinci SP platform: Feasibility and early outcomes from the first...

Single-port robot-assisted partial nephrectomy (SP-RAPN) is an emerging minimally invasive technique that integrates all instruments through a single multichannel port. Despite its increasing international use, European experience remains limited and no prior clinical series have been reported in Spain. This study aims to assess the feasibility, perioperative safety, and early outcomes of SP-RAPN in the first Spanish institutional experience.

Prospective observational study including the first eight consecutive patients undergoing SP-RAPN at a high-volume RAPN centre. Surgical approach was selected according to tumour location. Perioperative parameters, postoperative recovery, renal function at 3 months, and pathological outcomes were collected.

All procedures were completed successfully without conversion. Mean tumour size was 33 mm and mean RENAL score 7. Access was transperitoneal in 50%, pure retroperitoneal in 25%, and SARA/LAA in 25% of cases. Mean warm ischemia time was 19 min and mean operative time 123 min. Estimated blood loss was low (125 mL), and no transfusions were required. Only one minor complication (Clavien I) occurred. Serum creatinine remained stable postoperatively and at 3 months. Final pathology confirmed renal cell carcinoma in 7 patients, with negative surgical margins in 87.5%. Early recurrence-free survival was 100%.

SP-RAPN is a feasible, reproducible, and safe procedure for localized T1 renal tumours. Perioperative, functional, and oncologic outcomes were favourable and within the ranges reported for RAPN in contemporary series. The versatility of transperitoneal, retroperitoneal, and SARA/LAA approaches may further expand its indications. Future multicentre studies with larger cohorts and long-term follow-up will be essential to confirm the durability and clinical benefits of this promising technique.