Initial Experience 100 Cases of Colorectal Surgery Using the da Vinci Single-Port Robotic System

Background: Robot-assisted surgery for colorectal cancer has gained prominence in Japan since its insurance coverage in 2018. The recent da Vinci Single-Port (SP) system enables single-incision surgery, which is expected to improve cosmesis and reduce invasiveness. We analyzed the initial 100 cases performed using the da Vinci SP system to evaluate safety and feasibility. Methods: Patients with resectable primary colorectal cancer operated at our institution between January and August 2025 using the SP system were retrospectively reviewed. The surgeons had experience with more than 40 da Vinci Xi cases. Patient demographics, surgical history, procedure type, additional port use, operative time, blood loss, docking and console times, postoperative complications, length of hospital stay, and pathologic findings were assessed. Results: The cohort comprised 47 men and 53 women (median age: 74 y). The tumors were located in the colon (72) and rectum (28). An additional assistant port was required in 29 cases. The median operation time was 187 minutes, blood loss was 0 mL, docking time was 15 minutes, and console time was 103 minutes. Despite the absence of intraoperative complications, conversion to laparoscopy was required in 2 cases. Postoperative complications of Clavien-Dindo grade ≥II occurred in 7 patients. The median hospital stay was 8 days, and the median number of harvested lymph nodes was 18. Conclusions: Colorectal surgery using SP is safe and feasible, with short-term outcomes comparable to those of multiport robotic surgery. Right-sided colon surgeries were safely performed with minimal use of additional ports. Additional studies are required to compare SP with other robotic platforms, such as the da Vinci Xi, and to evaluate long-term outcomes.