Defining the Role of Single-Port Robotic Partial Nephrectomy: Current Evidence, Patient Selection, and...

To critically review the contemporary evidence on single-port robot-assisted partial nephrectomy (SP-RAPN), focusing on comparative outcomes, patient selection, anatomy-based surgical approaches, technical implementation, and its current role relative to multi-port RAPN (MP-RAPN).

Available comparative studies, multicenter registries, and recent meta-analyses indicate that SP-RAPN achieves perioperative, functional, and early oncological outcomes comparable to MP-RAPN in appropriately selected patients. Its principal added value appears to lie not in universal platform superiority, but in facilitating anatomy-adapted strategies, particularly retroperitoneal and low anterior access approaches in posterior tumors, confined operative spaces, and selected patients with hostile abdomen. However, current evidence remains predominantly retrospective and derives largely from high-volume expert centers. SP-RAPN should be considered a complementary robotic platform. Its greatest clinical value emerges when platform-specific engineering characteristics are matched to patient anatomy, surgical access, institutional experience, and surgeon expertise. Future studies should validate objective selection criteria and assess long-term, patient-reported, and efficiency outcomes.