Early experience with the SHURUI single port serpentine arm robotic system with an auxiliary port in gastrointestinal surgery: a descriptive case series

Background The SHURUI single-port (SP) robotic system is a novel platform with serpentine instruments designed for reduced-access surgery. Clinical experience in gastrointestinal malignancies remains limited. This exploratory, descriptive case series reports initial technical experience with the SHURUI SP system in a consecutive series of gastric and colorectal cancer resections. Methods This retrospective case series included six consecutive patients who underwent SP robotic gastrointestinal cancer surgery between November 2025 and December 2025 at a single tertiary center. Procedures comprised rectal cancer resection with total mesorectal excision ( n = 2), left hemicolectomy ( n = 1), right hemicolectomy with D2 lymphadenectomy ( n = 1), distal gastrectomy with D2 lymphadenectomy ( n = 1), and total gastrectomy with extended D2 lymphadenectomy ( n = 1). All cases used a single periumbilical incision (3–4 cm) and a 12 mm auxiliary port for energy devices and staplers. Outcomes included operative parameters, complications (Clavien-Dindo), pathological metrics, and hospital costs. Results All six procedures were completed without conversion. Median operative time was 332.5 min (155–402); median estimated blood loss was 70 mL (10–200). No intraoperative complications or transfusions occurred. Postoperative Grade II complications occurred in two patients (33.3%): anastomotic bleeding requiring transfusion and wound infection. Grade I transient fever occurred in two additional patients (33.3%). No Grade III–V complications, reoperations, or 30-day mortality occurred. All resections achieved R0 margins; median lymph node yield was 18.5 (12–28). Median hospital stay was 14 days (12–20). Mean total hospital cost was ¥30,573 ± ¥14,725, exclusive of robotic platform and instrument fees, which were waived during this initial evaluation period. Conclusions In this initial series, the SHURUI SP robotic system achieved complete resection without conversion in all six cases. R0 resection was obtained in every case with no severe early complications; however, the small sample size precludes definitive safety assessment, and oncologic adequacy requires long-term follow-up. The system proved technically feasible for complex gastric and colorectal cancer resections, though the absence of an integrated energy channel necessitated an auxiliary port in all cases, and operative times reflected an early learning curve. Larger comparative studies with long-term follow-up are needed to define the role of this platform.