Application value of domestical developed single‑port serpentine‑arm robotic system in gastro-intestinal surgery

Objective To investigate the application value of domestical single‑port serpentine-arm robotic system in gastrointestinal surgery.

Methods The single center exploratory prospective cohort study was conducted. The clinicopathological data of 31 patients who underwent domestically developed single-port serpentine‑arm robotic‑assisted gastrointestinal surgery at Nanfang Hospital, Southern Medical University from April to December 2025 were collected. There were 12 males and 19 females, aged 59 (range, 50-69) years. Observation indicators: (1) surgical conditions; (2) post-operative conditions. Measurement data with skewed distribution were expressed as M (range), and count data were expressed as absolute numbers.

Results (1) Surgical conditions: all 31 patients completed single‑port robotic‑assisted surgery successfully, without conversion to open surgery or laparoscopy. No surgery‑related adverse events occurred intraoperatively. The operation time, tele-operation time, and volume of intraoperative blood loss of all 31 patients were 243.0 (range, 156.0-345.0) minutes, 151.0 (range, 90.0-238.0) minutes, and 20.0 (range, 10.0-20.0) mL, respectively. All 31 patients were classified by surgical methods, including ① 13 patients undergoing partial gas-trectomy. The operation time was 177.0 (range, 142.5-266.5) minutes, the teleoperation time was 107.0 (range, 64.0-176.5) minutes, and the volume of intraoperative blood loss was 10.0 (range, 5.5-32.5) mL. ② Five patients underwent distal subtotal gastrectomy. The operation time of 4 cases of gastric cancer was 413.5 (range, 355.0-515.5) minutes, with the teleoperation time of 327.0 (range, 281.3-387.8) minutes and the volume of intraoperative blood loss of 25.0 (range, 12.5-45.0) mL. The operation time of 1 case of gastric stromal tumor was 345.0 minutes, with teleoperation time of 258.0 minutes and the volume of intraoperative blood loss of 20.0 mL. ③ One patient with gastric stump cancer underwent partial remnant gastrectomy. The operation time was 360.0 minutes, with the teleoperation time of 154.0 minutes and the volume of intraoperative blood loss of 50.0 mL. ④ Twelve patients underwent colorectal resection. The operation time 11 cases receiving radical resection of colorectal cancer was 199.0 (range, 145.0-301.0) minutes, with the teleoperation time of 120.0 (range, 59.0-213.0) minutes and the volume of intraoperative blood loss of 20.0 (range, 10.0-20.0) mL. The operative time of 1 case of ileocecal colonic polyp was 277.0 minutes, with the telepostoperative time of 174.0 minutes and the volume of intraoperative blood loss of 20.0 mL. (2) Postoperative conditions: postoperative complications of Clavien‑Dindo grade Ⅱ occurred in 4 of the 31 patients, all of whom were improved after symptomatic treatment. The duration of postoperative hospital stay for the 31 patients was 6 (range, 5-7) days, with no unplanned readmission within 30 d postoperatively. Of 31 patients, the number of lymph nodes harvested was 20.5 (13.0-30.3) for 16 patients with gastric and colorectal cancer, all of whom achieved R₀ resection. Among them, the 4 gastric cancer patients had pathological stage Ⅰ and Ⅱ in 2 and 2 cases, respectively. The number of lymph nodes harvested was 17.0 (13.3-28.3). One patient with gastric stump cancer had patho-logical stage Ⅱ, and the number of lymph nodes harvested was 8. The 11 colorectal cancer patients had pathological stage Ⅰ, Ⅱ, and Ⅲ in 5, 1, and 5, respectively. The number of lymph nodes harvested was 24.0 (13.0-31.0).

Conclusion In highly selected patients and when performed by a team with substantial experience in multi‑port robot‑assisted gastrointestinal surgery, the domestic single‑port serpentine‑arm robotic system shows preliminary technical feasibility and short‑term safety for gastrointestinal procedures.