Safety and feasibility of novel single-port robotic systems in colorectal cancer surgery: a comparative study with the da Vinci Xi system

PURPOSE: To compare perioperative outcomes and safety between the novel single-port robotic systems (SPRS) and the da Vinci Xi robotic system (DVRS) in radical colorectal cancer resection. METHODS: In this retrospective cohort study, 59 patients who underwent curative colorectal resection were assigned to either the SPRS group (n = 21) or the DVRS group (n = 38). Intraoperative metrics, postoperative recovery parameters, and complications were compared between groups. RESULTS: All procedures were successfully completed without open conversion and the number of lymph nodes harvested was comparable. The SPRS group demonstrated significantly longer operative times (298.86 ± 76.08 min vs. 227.84 ± 70.20 min; p < 0.001). No significant differences were observed in estimated blood loss, time of gastrointestinal recovery(first flatus), time of dietary resumption (liquid/soft diet), or 30-day readmission rates (p > 0.05). The DVRS group exhibited prolonged median postoperative hospitalization (10.00 days [IQR 8.00-11.75] vs. 8.00 days [IQR 7.00-9.00]; p < 0.05). Patients in the SPRS group reported significantly higher satisfaction scores regarding the cosmetic appearance of postoperative scars compared to those in the DVRS group(7.71 ± 1.01 vs. 6.66 ± 0.91; p < 0.001). Complication rates showed no statistical difference (p > 0.05). All complications were Clavien-Dindo grade I-II managed conservatively, except one SPRS case requiring endoscopic intervention for grade IIIa gastrointestinal hemorrhage. CONCLUSIONS: The novel single-port robotic systems are safe and feasible for radical colorectal cancer surgery. They achieve short-term outcomes comparable to the da Vinci Xi system, with the advantages of a shorter hospitalization and better cosmetic outcomes but at the expense of a longer operative time.