Biasatti Arianna, Soputro Nicolas A, Porpiglia Francesco, Perdonà Sisto, Abdollah Firas, Nelson Ryan, Rogers Craig, Zhao Lee C, Ghazi Ahmed, Challacombe Ben, Eden Christopher, Mattei Agostino, Fankhauser Christian D, Breda Alberto, Rocco Bernardo, Montorsi Francesco, Briganti Alberto, Pellegrino Antony A, Mottrie Alexandre, De Groote Ruben, Haese Alexander, Graefen Markus, Moschovas Marcio C, Patel Vipul, Simone Giuseppe, Galfano Antonio, Secco Silvia, Bertolo Riccardo, Pandolfo Savio D, Pansadoro Vito, Carvalho Filipe L F, Joseph Jean V, Ramadan Mohammad, Shakuri-Rad Jaschar, Yuh Bertram, Nix Jeffrey, Lee David I, Rais-Bahrami Soroush, Hemal Sij, Eltemamy Mohamed, Beksac Alp T, Schwen Zeyad, Su Li-Ming, Buscarini Maurizio, Palese Michael, Tewari Ash, Wiklund Peter, Cherullo Edward E, Vourganti Srinivas, Linehan Jennifer A, Wu Zhenjie, Stifelman Michael, Ahmed Mutahar, Mehrazin Reza, Badani Ketan, Link Richard E, Crivellaro Simone, Kaouk Jihad, Autorino Riccardo
Department of Urology, Rush University Medical Center, Chicago, IL, USA.
Urologic Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Nat Rev Urol. 2025 Sep 2. doi: 10.1038/s41585-025-01081-z.
The advent of the purpose-built da Vinci single-port robotic platform marks a pivotal advancement in minimally invasive urological surgery. Designed to overcome the ergonomic and technical limitations of prior single-site approaches, the single-port system enables complex procedures through a single incision, with enhanced dexterity, optimized use of confined spaces and improved cosmetic and peri-operative outcomes. The single-port system has been increasingly used across a wide range of urological indications, including robot-assisted radical prostatectomy, partial nephrectomy, nephroureterectomy and reconstructive surgeries such as pyeloplasty and ureteral re-implantation. Innovative access strategies, such as the single-port transvesical and low anterior access approaches, have facilitated regionalized and multi-quadrant surgeries without the need for repositioning or robot re-docking. These advances have translated into reduced morbidity, faster recovery and increased feasibility of opioid-sparing, same-day discharge protocols. As surgical expertise deepens and technology evolves, the single-port robotic platform stands as a refinement of minimally invasive surgery, and also as a potential paradigm shift in urological practice.
专用的达芬奇单孔机器人平台的出现标志着微创泌尿外科手术的一项关键进展。单孔系统旨在克服先前单部位手术方法在人体工程学和技术方面的局限性,能够通过单一切口进行复杂手术,具有更高的灵活性、对有限空间的优化利用以及更好的美容效果和围手术期结果。单孔系统已越来越多地用于广泛的泌尿外科适应症,包括机器人辅助根治性前列腺切除术、部分肾切除术、肾输尿管切除术以及诸如肾盂成形术和输尿管再植术等重建手术。创新的入路策略,如单孔经膀胱和低位前入路方法,无需重新定位或机器人重新对接即可促进区域化和多象限手术。这些进展已转化为发病率降低、恢复更快以及增加了减少使用阿片类药物、当日出院方案的可行性。随着手术专业知识的深化和技术的发展,单孔机器人平台不仅是微创手术的一种改进,也是泌尿外科实践中潜在的范式转变。