Transferring robotic expertise from multi-port to single-port partial nephrectomy: A comparative analysis of...

The objective of this study is to evaluate perioperative outcomes and learning curves following implementation of single-port robot-assisted partial nephrectomy (SP-RAPN) at a European tertiary referral centre and to assess the transferability of robotic expertise from established multi-port (MP) platforms to single-port (SP) surgery.

This single-centre retrospective cohort study included consecutive patients undergoing RAPN between February 2023 and August 2025. Procedures were performed by four surgeons (two experts and two trainees) using da Vinci Xi MP or da Vinci SP systems. Primary outcomes included operative time, warm ischemia time, complications and trifecta (negative margins, ischemia ≤25 min and no major complications). Learning curves were analyzed using risk-adjusted CUSUM methodology.

MP-RAPN was performed in 65 patients and SP-RAPN in 62. Mean operative time was 193 min in both groups, and trifecta was 80% for MP-RAPN versus 69% for SP-RAPN (p = 0.17); however, given the limited sample size, we could not rule out a clinically meaningful difference. Intraoperative complications occurred in three MP-patients (5%) and in no SP-patients. Length of stay was significantly shorter following SP-RAPN (2 vs. 3 days, p < 0.001). CUSUM analysis demonstrated a potential learning curve in experienced surgeons (R ² = 0.91, proficiency at case 18), with patterns in other surgeons limited by case volume.

SP-RAPN can be safely implemented in experienced robotic centres with outcomes comparable to MP approaches and shorter hospital stays. Excellent skill transferability from MP to SP platforms was demonstrated in experienced surgeons. Supervised trainee adoption was feasible without complications.