Single Port Robotic Surgery in Benign Urologic Disease - A Review of Contemporary Applications and Outcomes

The advent of the Intuitive da Vinci single-port (SP) robotic system represents a pivotal evolution in minimally invasive urologic surgery, offering enhanced dexterity, improved surgical ergonomics, and reduced patient morbidity. This review is designed to provide a comprehensive evaluation of current literature regarding the feasibility, efficacy, cost considerations, and clinical applications of the SP platform across various benign urologic surgeries including pyeloplasty, ureteral reconstruction, donor nephrectomy, renal auto-transplantation, partial cystectomy, and simple prostatectomy. The review also analyzes current limitations of the robotic platform including a narrower range of available instruments, diminished instrument grip strength, and a steeper learning curve.

Across these procedures, the SP system demonstrates comparable operative outcomes when compared to multi-port (MP) and open approaches. The SP system also has notable advantages in postoperative analgesia, incisional cosmesis, and hospital length of stay. The system's low-profile design and ability to maintain an extraperitoneal approach confer distinct benefits in patients with complex surgical histories or hostile abdomens. Although the SP platform incurs higher disposable instrument costs, overall expenditures are mitigated with decreased hospital length of stay and reduced postoperative care requirements. As surgical experience and technological refinements progress, the SP robotic platform is anticipated to achieve broader integration in benign urology. Overall, SP robotic surgery offers a safe, effective, and patient-centered alternative to established minimally invasive techniques with the potential to further optimize perioperative outcomes and redefine the standard of care in contemporary urologic practice.