Single-port robotic colorectal resection: outcomes in 138 consecutive patients

Single-port robotic (SPr) colorectal surgery represents an emerging minimally invasive technique with limited data regarding its safety and outcomes. This study of a large series of SPr abdominal colorectal resections, focuses on feasibility, safety, and early perioperative outcomes. From an IRB approved, prospectively maintained database, we identified all elective SPr colorectal resections with abdominal approaches performed between 10/2018 and 3/2026. Patient demographics, indications for surgery, procedures, perioperative outcomes, and postoperative outcomes were evaluated. We identified 138 consecutive patients. Mean age was 59 years (range 21-87) and BMI was 26.7 kg/m² (15.3-42.6). Females accounted for 62% of the study population. 45.7% had prior abdominal surgery. Resections included right-sided (32.6%), left-sided (37%), pelvic (28.3%) and total abdominal colectomy (2.2%). Intraoperative complications rate was 1.5%, with no conversions to open. Diverting stomas were created in 14.5% of cases. Pathology included diverticular disease (38.4%), malignancy (37%), inflammatory bowel disease (9.4%), and other benign conditions (15.2%). The 30-day morbidity was 15.2%, with Clavien-Dindo grade ≥ III complications occurring in 5.1%. There were no 30-day mortalities. This series demonstrates that SPr colorectal resection via abdominal approach is a feasible and safe technique across a broad spectrum of benign and malignant colorectal diseases. It represents one of the largest reported experiences of SPr colorectal abdominal resections to date, reporting favorable perioperative patient outcomes and acceptable morbidity. Future SPr enhancements, including dedicated stapling, vessel-sealing, and suction instruments, will lead to broader platform adoption and may further optimize patient safety and outcomes.