Single-port robotic system - a paradigm shift in robot-assisted radical prostatectomy?

Introduction: Robotic-assisted radical prostatectomy (RARP) has become a cornerstone in the surgical management of prostate cancer. This study evaluates the potential of the Da Vinci single-port (SP) system, which represents a significant advancement in minimally invasive surgery.

Areas covered: A narrative review was conducted using PubMed and Scopus databases to identify relevant studies published between January 2018 and February 2025. Search terms included 'single-port robotic prostatectomy,' 'Da Vinci SP system,' and 'robot-assisted radical prostatectomy.' Studies comparing SP and multi-port (MP) systems were prioritized. The SP system is discussed in terms of its technical innovations, including 360° operative field visualization, integrated optics and instruments, and enhanced depth perception. Clinical benefits, such as reduced blood loss, faster recovery, improved cosmetic outcomes, and reduced surgical trauma, are highlighted. Comparisons are drawn between the SP and multi-port systems, focusing on oncological and functional outcomes, as well as the challenges associated with the SP system's steeper learning curve.

Expert opinion: The SP system holds great promise in advancing patient care in RARP, particularly through its minimally invasive approach. While achieving comparable outcomes to MP systems, it uniquely reduces surgical trauma. However, successful implementation requires overcoming technical challenges and adapting to the learning curve. Future research should focus on refining the technology and exploring its long-term impact on clinical outcomes.