July- 20208In My OpinionIMPLICATIONS OF SINGLE-PORT ROBOTIC SURGICAL TECHNOLOGY: GAME CHANGER OR INCREMENTAL IMPROVEMENT?At the end of 2018, Intuitive Surgical released the da Vinci SP robot, the first single-port surgical robot to reach the market and as yet the only one of its kind in clinical use. The concept entails miniaturizing the robotic arms used in robotic surgery to allow them to enter through a single channel rather than requiring a port and separate robotic arm for each instrument to enter the abdomen, chest, or other body cavity. The natural question for a surgeon before investing in learning to use this new robot or as a hospital before investing in this new and expensive technology is whether or not this is a significant leap forward.The answer, as with many things in healthcare, is that it is complicated. For some types of surgery, the SP robot is definitely a game changer because it allows access into the body through natural orifices and can work in tight spaces. So for trans-oral surgery for throat cancers, for example, or for transanal surgery for rectal cancers, for example, a patient will literally have no incision after their tumors have been resected as opposed to an often morbid alternative like splitting the jaw to access the tumor or a large abdominal incision. Operations that previously would have required several days of hospitalization and weeks of recovery can be done on an outpatient basis or overnight stay.On the other hand, many operations have been performed robotically for over a decade and at a very high level with excellent outcomes. Almost all prostate cancer and endometrial cancer surgery in the U.S. is already done robotically and for almost two decades with other common procedures like robotic hysterectomy, hernia repairs, and kidney surgery continuing to grow. Will replacing five smaller incisions for robotic instruments with one, approximately inch-long incision truly impact patient care? This remains to be seen, but early outcomes in Urology (the SP robot is only FDA-approved so far for certain urologic and otolaryngologic procedures) suggest that using the SP robot with minor modifications to the tried and true robotic methods might decrease patient pain and allow earlier discharge.Ronney Abaza, M.D., F.A.C.S., OhioHealth Dublin Methodist HospitalBy
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