Single-port robotic surgery

What the SP platform is

The SP has a single boom that enters through one port. Inside the patient the instruments and camera triangulate so that the surgeon still has the conventional robotic view and working angles. The trade-off is a smaller external footprint at the cost of a more confined internal working space.

Where SP is a good fit

SP has an emerging role in the following urological operations:

• Radical prostatectomy - particularly extraperitoneal approaches that avoid disturbance of bowel and allow early catheter removal in selected cases.
• Partial nephrectomy of favourably located tumours.
• Simple prostatectomy for very large benign prostates.
• Pyeloplasty and other upper-tract reconstruction in selected cases.
• Adrenalectomy for small, favourable adrenal tumours.

Where SP is not the right tool

Not every operation benefits. Multi-quadrant work (for example, robotic cystectomy with intracorporeal diversion, or radical nephrectomy with extensive lymphadenectomy) typically still needs the Xi. Complex reconstructive or oncologic cases are an Xi discussion.

Reported benefits

• A single small scar rather than several.
• Reduced post-operative analgesic requirement in some series.
• Same 10x 3D vision, wristed instruments and tremor filtering as the Xi platform.

Current limits

• SP systems are still relatively uncommon in Australia. Dr Kooner runs a dedicated SP program at St Vincent's.
• Working space inside the patient is smaller, so case selection matters more than with Xi.
• Long-term comparative evidence is still maturing; early series are encouraging but smaller than the Xi evidence base.