Applying Robot-Assisted Single-Port Laparoscopic Surgery in Gynecology: Technological Paradigm Innovations and Clinical Advances
Abstract
With the continuous development of robot-assisted single-port laparoscopic surgery in gynecology, its indications have gradually expanded from benign gynecologic diseases to malignant tumors, reflecting an emerging trend toward the integration of robotic technology and single-port minimally invasive surgery. This review primarily discusses the clinical application of robotic systems such as the da Vinci Xi platform and domestically developed single-port robotic systems in various complex surgical procedures, as well as the development of technical strategies for optimizing instrument layout and overcoming operative limitations. From a technical perspective, the use of 3-dimensional high-definition visualization, flexible wristed instrumentation, and tremor filtration, combined with innovative surgical paradigms, has effectively addressed the problem of instrument interference in single-port surgery, thereby enabling precise resection, rapid postoperative recovery, and superior cosmetic outcomes with minimal visible scarring. Although dedicated single-port systems still face technical challenges and long-term outcome data remain limited, the future integration of artificial intelligence and remote technologies will further validate their clinical efficacy and promote the standardized application of this approach in gynecological clinical practice.
Keywords: Robot-assisted surgical system, Single-port laparoscopic surgery, Gynecological surgery, Review
Full Text:
PDFReferences
APPELBAUM H. Perioperative and operative considerations for minimally invasive surgery in pediatric and adolescent gynecology. J Pediatr Adolesc Gynecol, 2025, 38(1): 18-25. doi: 10.1016/j.jpag.2024.07.006.
JIANG X, ZUO X, ZHU H. Laparoendoscopic single-site technique contrasted with conventional laparoscopy in cystectomy for benign ovarian cysts. Curr Ther Res Clin Exp, 2023, 99: 100713. doi: 10.1016/j. curtheres.2023.100713.
CHEN L, ZHENG Y, MIN L, et al. Clinical cohort study of total hysterectomy via transvaginal natural orifice transluminal endoscopic surgery and transumbilical laparoendoscopic single site surgery. Chinese Journal of Obstetrics and Gynecology, 2020, 55(12): 843-847. doi: 10. 3760/cma.j.cn112141-20200309-00193.
KIM K. Single-port robotic posterior retroperitoneoscopic adrenalectomy: current perspectives, technical considerations, and future directions. J Clin Med, 2025, 14(7): 2314. doi: 10.3390/jcm14072314.
OH S, YI J, SHIN J H. Single port robotic assisted sacrocolpopexy using retroperitoneal tunneling technique. J Minim Invasive Gynecol, 2025, 32(6): 500. doi: 10.1016/j.jmig.2025.02.005.
LEE H H, NA J C, YOON Y E, et al. Robot-assisted laparoendoscopic single-site upper urinary tract surgery with da Vinci Xi surgical system: initial experience. Investig Clin Urol, 2020, 61(3): 323-329. doi: 10.4111/icu.2020.61.3.323.
LÓPEZ-HUERTA A, REYES-DÍAZ M L, BONILLA-COZAR M A, et al. Evaluating short- and long-term clinical outcomes of robotic rectal cancer surgery: a comparison of da Vinci S and Xi systems. J Robot Surg, 2025, 19(1): 720. doi: 10.1007/s11701-025-02844-x.
BIANCO F M, DREIFUSS N H, CHANG B, et al. Robotic single-port surgery: Preliminary experience in general surgery. Int J Med Robot, 2022, 18(6): e2453. doi: 10.1002/rcs.2453.
OCHI T, SUZUKI H, HIRAI Y, et al. Robot-assisted thoracic surgery versus video-assisted thoracic surgery for mediastinal lesions. J Thorac Dis, 2023, 15(7): 3840-3848. doi: 10.21037/jtd-23-377.
LIU Y, GAO H, HUANG G, et al. Single-port robot-assisted laparoscopic pyeloplasty in an infant: A video case report with 9 months follow up. J Pediatr Urol, 2022, 18(5): 704-705. doi: 10.1016/j.jpurol.2022.07.019.
SUDA T, MOROTA M, NEGI T, et al. Subxiphoid uniportal robotic thymectomy using da Vinci Xi system†. Eur J Cardiothorac Surg, 2025, 67(4): ezaf127. doi: 10.1093/ejcts/ezaf127.
CHEN Y, ZHENG Y, YANG F, et al. Comparison of robotic and conventional laparoendoscopic single-site hysterectomy for large uterus using da Vinci Xi system: A propensity score matching analysis. Eur J Obstet Gynecol Reprod Biol, 2025, 307: 252-257. doi: 10.1016/j.ejogrb.2025.02.036.
CHEN Y, YANG F, WANG Q, et al. Robotic laparoendoscopic single-site surgery by da Vinci Xi system in gynecology: a retrospective series of 721 cases. BMC Surg, 2025, 25(1): 608. doi: 10.1186/s12893-025-03331-8.
MARCHAND G, ULIBARRI H, ARROYO A, et al. The feasibility and surgical outcomes of robotic vaginal natural orifice transluminal endoscopic single port hysterectomy for benign gynecologic diseases: a systematic review and meta-analysis. AJOG Glob Rep, 2025, 5(3): 100512. doi: 10.1016/j.xagr.2025.100512.
WAGAR M K, SOBECKI J N, CHANDERENG T, et al. Postoperative venous thromboembolism in gynecologic oncology patients undergoing minimally invasive surgery: does modality matter? Gynecol Oncol, 2021, 162(3): 751-755. doi: 10.1016/j.ygyno.2021.06.011.
SU M C, ZHENG Y, YANG F, et al. Placement of robotic single-site surgery with the tumor-free technique for early cervical cancer using the da Vinci Xi platform. Asian J Surg, 2023, 46(3): 1492-1493. doi: 10.1016/j. asjsur.2022.09.049.
CHEN Y, ZHENG Y, YANG F. Primary debulking surgery for advanced epithelial ovarian cancer with isolated enlarged para-aortic lymph node by robotic transumbilical single port approach. Int J Gynecol Cancer, 2023, 33(12): 1976-1977. doi: 10.1136/ijgc-2023-004729.
LI F, LIU J, YANG X, et al. R-LESS endometrial cancer comprehensive staging surgery with RV-level lymphadenectomy. In: 33rd Annual Congress of the European Society for Gynaecological Endoscopy (ESGE). Marseille, 2024.
王卡娜, 陈思敬, 郑莹. 郑氏4C悬吊法在经脐单孔腹腔镜妇科恶性肿瘤手术中的应用. 中华腔镜外科杂志(电子版), 2021, 14(1): 5-9. doi: 10. 3877/cma.j.issn.1674-6899.2021.01.002.
WANG K N, CHEN S J, ZHENG Y. "Zheng's 4C suspension method" used in the transumbilical single single-site surgery (TU-LSSS) of gynecologic cancer. Chinese Journal of Laparoscopic Surgery (Electronic Edition), 2021, 14(1): 5-9. doi: 10.3877/cma.j.issn.1674-6899.2021.01.002.
HOSHIKAWA Y, ISHIZAWA H. Robotic Mediastinal Tumor Surgery Using da Vinci Single-port (SP) Surgical System. Kyobu Geka, 2025, 78(10): 849-855.
BILLAH M S, STIFELMAN M, MUNVER R, et al. Single port robotic assisted reconstructive urologic surgery-with the da Vinci SP surgical system. Transl Androl Urol, 2020, 9(2): 870-878. doi: 10.21037/tau.2020.01.06.
GARDEN E B, Al-ALAO O, RAZDAN S, et al. Robotic single-port donor nephrectomy with the da Vinci SP Surgical System. JSLS, 2021, 25(4): e2021.00062. doi: 10.4293/JSLS.2021.00062.
AMINSHARIFI A, SAWCZYN G, WILSON C A, et al. Technical advancements in robotic prostatectomy: single-port extraperitoneal robotic-assisted radical prostatectomy and single-port transperineal robotic-assisted radical prostatectomy. Transl Androl Urol, 2020, 9(2): 848-855. doi: 10.21037/tau.2019.11.35.
SOPUTRO N A, KAOUK J. Single-port robot-assisted radical prostatectomy. World J Urol, 2024, 42(1): 245. doi: 10.1007/s00345-024-04914-5.
RAMOS R, SOPUTRO N, PEDRAZA A M, et al. Single port transvesical robot assisted radical prostatectomy. J Endourol, 2025, 39(S1): S39-S46. doi: 10.1089/end.2024.0291.
LI C, ZHU X Y, GONZALEZ-RIVAS D, et al. Single-port robot-assisted thoracoscopic right lower bronchial sleeve lobectomy utilizing the Shurui single-port robotic system. J Thorac Dis, 2024, 16(11): 7920-7925. doi: 10. 21037/jtd-24-957.
LEE J H, HONG J I, KIM H K. Single-port robotic subcostal major pulmonary resection using the single-port robotic system. World J Surg, 2024, 48(3): 713-722. doi: 10.1002/wjs.12051.
PISOTSKYI O, PETRASZ P, ZORGA P, et al. Single-port robotic system -a paradigm shift in robot-assisted radical prostatectomy?Expert Rev Med Devices, 2025, 22(6): 569-579. doi: 10.1080/17434440.2025.2499661. DAIKO H. da Vinci single-port esophagectomy via the subcostal approach. Kyobu Geka, 2025, 78(10): 888-891.
KWAK Y H, LEE H, SEON K, et al. Da Vinci SP single-port robotic surgery in gynecologic tumors: Single surgeon's initial experience with 100 cases. Yonsei Med J, 2022, 63(2): 179-186. doi: 10.3349/ymj.2022.63.2.179.
ZHANG L, ZHOU H, WEN Z, et al. Initial urological surgery using a new domestic single-port surgical robotic system. J Endourol, 2025, 39(4): 375-380. doi: 10.1089/end.2024.0822.
GONG P, MAO H, HE T, et al. Initial outcomes and methodologies of a novel single-port robotic surgery in gynecology. JSLS, 2024, 28(4): e2024.00047. doi: 10.4293/JSLS.2024.00047.
JIANG Z, FENG Z, XU Y, et al. Single-port robotic resection of recurrent hepatocellular carcinoma in the right anterior lobe: a case report. Int J Med Robot, 2025, 21(4): e70092. doi: 10.1002/rcs.70092.
Refbacks
- There are currently no refbacks.



