Purpose/Background: This study evaluated the feasibility of single plus one-port robotic surgery (SPORS) compared to multi-port robotic surgery (MPRS) for low anterior resection.
Methods/Interventions: We retrospectively analyzed 32 MPRS and 16 SPORS cases performed between August 2018 and February 2024 at Konyang University Hospital. Perioperative, intraoperative, and postoperative outcomes including oncologic safety were compared. Non-inferiority testing, post hoc power analysis, multivariable regression, and cumulative sum (CUSUM) learning curve analysis were performed.
Results/Outcomes: SPORS showed numerically shorter total operative time (277.5 vs. 282.5 minutes, p = 0.437) and console time (162.5 vs. 199.0 minutes, p = 0.284). However, non-inferiority was not statistically confirmed (total operative time: β = –10.66, 95% CI –54.25 to 32.93; console time: β = –25.92, 95% CI –70.09 to 18.26). Time to oral intake was faster in SPORS despite the same median day (2.0 days), showing statistical significance (p=0.011) and non-inferior effect size (β = –0.34, 95% CI –0.60 to –0.08). Length of hospital stay was shorter in SPORS (6.0 vs. 7.0 days, p = 0.007). Multivariable regression confirmed faster oral intake and earlier drain removal in SPORS. Pathologic and oncologic outcomes showed no significant differences. CUSUM analysis demonstrated earlier stabilization in SPORS, with breakpoints at 7 cases for total operation time and 8 cases for robot console time, compared to 11 and 12 cases, respectively, in MPRS.
Conclusion/Discussion: SPORS is a feasible alternative to MPRS for low anterior resection, providing comparable perioperative and oncologic outcomes, with potential advantages in recovery and learning curve.
