Katsimperis Stamatios, Tzelves Lazaros, Feretzakis Georgios, Bellos Themistoklis, Douroumis Konstantinos, Kostakopoulos Nikolaos, Skolarikos Andreas
Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio Hospital, 15126 Athens, Greece.
School of Science and Technology, Hellenic Open University, 26335 Patras, Greece.
Cancers (Basel). 2025 Aug 29;17(17):2847. doi: 10.3390/cancers17172847.
The evolution of robotic surgery in urologic oncology has led to the emergence of single-port (SP) robotic systems as a potential alternative to the widely adopted multi-port (MP) platforms. This narrative review provides a comprehensive comparison between SP and MP robotic systems, the former of which received FDA approval in 2018 and CE marking in 2024, focusing on their application across radical prostatectomy, partial and radical nephrectomy, and radical cystectomy. Drawing from the most current literature, we examine perioperative outcomes, oncologic efficacy, postoperative recovery, and complication rates. The review highlights the technical challenges unique to SP surgery, including restricted triangulation, limited instrumentation, and a defined learning curve, while also emphasizing innovations such as transvesical prostatectomy and the Supine Anterior Retroperitoneal Access (SARA) approach. Additionally, we explore the potential impact of emerging technologies-such as artificial intelligence, augmented reality, and telesurgery-on the future of SP platforms. Despite early limitations, SP systems have demonstrated comparable safety and effectiveness in selected cases and may offer unique advantages in specific anatomical scenarios. Continued innovation, structured training, and robust long-term outcome data will be essential for the broader adoption and integration of SP robotic surgery in clinical practice.
泌尿外科肿瘤学中机器人手术的发展促使单孔（SP）机器人系统出现，成为广泛应用的多孔（MP）平台的一种潜在替代方案。本叙述性综述对SP和MP机器人系统进行了全面比较，前者于2018年获得美国食品药品监督管理局（FDA）批准，并于2024年获得欧洲合格认证（CE标志），重点关注它们在根治性前列腺切除术、部分和根治性肾切除术以及根治性膀胱切除术中的应用。借鉴最新文献，我们研究了围手术期结果、肿瘤学疗效、术后恢复情况和并发症发生率。该综述强调了SP手术特有的技术挑战，包括受限的三角定位、有限的器械操作以及明确的学习曲线，同时也强调了经膀胱前列腺切除术和仰卧位前腹膜后入路（SARA）等创新方法。此外，我们探讨了人工智能、增强现实和远程手术等新兴技术对SP平台未来的潜在影响。尽管存在早期局限性，但SP系统在特定病例中已显示出 comparable safety and effectiveness ，并且在特定解剖情况下可能具有独特优势。持续创新、结构化培训以及强大的长期结果数据对于SP机器人手术在临床实践中的更广泛应用和整合至关重要。
