Seoul St. Mary's Hospital Team Confirms Clinical Superiority of Single-Port Robotic Surgery

Academic Award in the International Submission Paper Category
at the Annual Meeting of the Korean Endourological Society

The research team led by Professors Hong Seonghoo and Bang Seokhwan from the Department of Urology at Seoul St. Mary's Hospital, Catholic University of Korea, announced on the 30th that they have demonstrated through clinical results that single-port robotic surgery, which removes kidney tumors through a small incision without opening the abdominal cavity, shortens operation time, enables faster recovery, and provides surgical efficacy equal to or greater than conventional multi-port surgery.

(From left) Sunghoo Hong and Seokhwan Bang, Professors of Urology at Seoul St. Mary's Hospital, Catholic University. Seoul St. Mary's Hospital

This study is the first comparative research in Korea to objectively demonstrate the clinical superiority of single-port robotic surgery, which approaches through the retroperitoneum without opening the abdominal cavity. Recently, it was honored with the Academic Award in the International Submission Paper category at the 31st Annual Meeting of the Korean Endourological Society.

The research team conducted a retrospective comparative study on 125 patients with kidney tumors who underwent retroperitoneal robotic partial nephrectomy at Seoul St. Mary's Hospital from September 2021 to March 2023. Of these, 81 patients underwent multi-port robotic surgery, while 44 underwent single-port robotic surgery. To minimize patient selection bias, propensity score matching (PSM) analysis was performed, and a total of 88 patients?44 in each group?were ultimately included in the final analysis.

The analysis showed that single-port robotic surgery outperformed in several key indicators. The most notable result was observed in the warm ischemia time, a crucial indicator for preserving kidney function. The warm ischemia time in the single-port robotic surgery group was 13.8±4.6 minutes, which was 3.4 minutes shorter than the 17.2±6.6 minutes in the multi-port group, representing a statistically significant difference (p=0.007). This corresponds to an approximately 19.8% reduction in ischemia time.

Operation time was also shorter in the single-port group, averaging 95.4±32.2 minutes, compared to 103.7±21.9 minutes in the multi-port group, a difference of 8.3 minutes. Other surgical indicators, such as blood loss, pain scores, and length of hospital stay, were either equivalent or showed better results in the single-port group.

The research team attributed the advantages of single-port robotic surgery to improved maneuverability within the limited retroperitoneal space. While conventional multi-port robotic surgery faced challenges due to interference between multiple ports and restricted working space, the single-port robot, with its wire-in-wire characteristics, allows for flexible movement even in narrow spaces.

Professor Hong Seonghoo explained, "Single-port robotic retroperitoneal partial nephrectomy significantly reduces ischemia time compared to conventional multi-port surgery, while demonstrating equivalent safety and efficacy. In particular, it may be a more suitable surgical option for younger female patients or those who prioritize cosmetic outcomes."

Professor Bang Seokhwan stated, "Until now, the use of single-port robotic surgery has been limited by maneuverability and device constraints, but this study has confirmed its potential and tangible benefits. Going forward, single-port surgery could become a standard treatment option even for patients with complex kidney tumors."

This study holds significant academic value as the first systematic comparative research on retroperitoneal partial nephrectomy using a single-port robot. The research paper was published in the December 2024 issue of the international urology journal 'Journal of Endourology'.