Single port robotic surgery

The starting point: standard robotic surgery

In standard robotic surgery, the surgeon uses four to six small cuts in the abdomen. Each cut is for a different instrument or for the camera. This is sometimes called multiport robotic surgery.

What single port surgery does differently

Single port (SP) surgery uses just one small cut - usually about 3 to 3.5 cm, low on the abdomen, often hidden below the waistband.

A specially designed cannula goes through this single cut. Inside it, the camera and three robotic instruments are all packed together. The instruments unfold inside the body and the operation is then carried out through that one access point.

The actual operation is exactly the same: the same anatomy, the same cancer-clearing steps, the same nerve-sparing and stitching. What changes is the route in.

Why this can matter

Two things drive the differences seen in published comparisons:

• Fewer cuts. One incision instead of four to six means less skin trauma and a single cosmetic result.
• A different route. Because everything goes through one tube, the SP system suits an approach that stays outside the main belly cavity. For prostate surgery, that means working in front of the bladder rather than going through the abdomen. For kidney surgery, it means working from behind. This avoids handling the bowel.

What the evidence shows so far

The evidence is newer and smaller than for standard robotic surgery, but it has grown quickly since 2020. Published systematic reviews show that, compared to standard multiport robotic prostatectomy, single port surgery is associated with:

• Slightly less blood loss.
• A shorter hospital stay (often one to two days, sometimes same-day).
• A small but consistent reduction in pain on day 1.
• Comparable cancer control, continence and erection outcomes at the follow-up so far reported (typically up to about 8 months).

What is not yet available is long-term cancer outcome data (5 years and beyond) at the same depth as exists for standard robotic surgery.

What single port is being used for

At Urology NSW, single port robotic surgery is used for selected patients having:

• Radical prostatectomy (for prostate cancer).
• Partial or radical kidney surgery (for kidney cancer).
• Pyeloplasty (rebuilding the kidney drainage).
• Adrenal surgery.
• Selected bladder and reconstructive procedures.

Whether it is suitable in a particular case depends on the size and place of the tumour or condition, the patient's anatomy, previous surgery, and overall health. Not every patient who could have robotic surgery is suitable for the single port approach.

Where this sits in Australia

The first da Vinci SP system in Australia was installed at Epworth Richmond in Victoria in 2025. St Vincent's Private Hospital, Sydney, is the first hospital in NSW to install it. On 15 January 2026, Dr Kooner completed the first pure single-incision robotic prostate procedure in NSW, after structured training and proctoring by an experienced overseas surgeon.