Single-Arm Robotic Surgery Applied for the First Time in Türkiye

The single-arm (single port) robotic surgical system, applied for the first time in Türkiye at Memorial Şişli Hospital, has opened the door to a new era in the surgical field. Thanks to this advanced technology, instead of the four to five separate incisions used in classic robotic surgeries, the operation can be performed through a single incision of approximately 2-2.5 cm.

The first clinical applications of this method in Türkiye were carried out by Prof. Dr. Murat Binbay in the Urology Department of Memorial Şişli Hospital. Single-arm robotic surgery represents a step beyond existing robotic systems both in terms of patient comfort and surgical precision.

A New Stage in Robotic Surgery: Surgery Through a Single Hole

Surgical technologies have in recent years undergone a clear evolution from open operations to laparoscopy and from laparoscopy to robotic surgery. Today the effectiveness and reliability of robotic surgery are scientifically proven. However, single-arm robotic surgery represents a new phase of this development.

In this system the surgical procedure is carried out by entering the body through only a single entry point. In this way tissue trauma decreases markedly and the postoperative recovery process speeds up. Single-arm robotic surgery offers the surgeon high manoeuvring capability and an advanced view advantage particularly in narrow and anatomically complex areas.

Less Trauma, Less Pain

One of the most important advantages of single-arm robotic surgery is that the surgical trauma applied to the patient is reduced to a minimum. The use of a single incision instead of multiple incisions allows the muscle, skin and nerve tissues to be better preserved.

The clinical results of this approach can be summarised as follows:

• Postoperative pain decreases markedly
• In most patients the need for additional painkillers is minimal
• The risk of bleeding is lower
• In most cases there is no need for the use of a drain
• The length of hospital stay is shortened

In suitable patients, discharge within one day after single-arm robotic surgery can be possible.

The First Application and First Clinical Experience in Türkiye

The application of single-arm robotic surgery for the first time in Türkiye is not only a technological innovation but at the same time an important step in terms of clinical experience. The first cases, carried out within a short time, have shown that the method can be applied safely and effectively.

Within the scope of the first clinical applications, numerous operations were carried out within a short period of time; in this process successful results were obtained without the use of a drain, with a low level of pain and with high patient satisfaction. This early experience shows that the areas of use of single-arm robotic surgery in our country can expand rapidly.

In Which Operations Is It Used?

The single-arm robotic surgical system can be used effectively in many surgical branches, foremost among them urology. In urology it stands out particularly in the following operations:

• Prostate cancer surgery (radical prostatectomy)
• Kidney cancer surgery (partial and radical nephrectomy)
• Benign prostatic hyperplasia (BPH) surgery
• Ureteropelvic junction obstructions
• Certain congenital strictures of childhood

Particularly in prostate cancer surgery, thanks to the angle and manoeuvring advantage offered by the single-arm system, it can be possible for nerve-sparing surgery to be applied in a more controlled way.

The Area of Application Is Not Limited to Urology

Single-arm robotic surgery is not limited only to urology. It is also opening the way for new approaches in different surgical disciplines:

• In obstetrics and gynaecology, surgeries performed vaginally without opening the abdomen
• In general surgery, procedures performed in selected rectal tumours while preserving bowel integrity
• In ear, nose and throat surgery, access to tumours of the base of the tongue from inside the mouth
• In thoracic surgery, safe and precise dissection in narrow anatomical areas

In this respect single-arm robotic surgery carries important potential for the future of multidisciplinary surgery.

It Is Not the Robot but the Surgeon Who Performs the Operation

One of the most frequently encountered misconceptions about robotic surgery is the thought that the robot performs the operation. Yet in all robotic systems, including single-arm robotic surgery, all control is with the surgeon.

The robot is an advanced assistant that filters, magnifies and makes more precise the surgeon's hand movements. In this way:

• Hand tremors are eliminated
• Image quality increases
• Bleeding control is achieved more effectively
• Nerve and vessel structures are better preserved

These features provide marked advantages particularly in function-preserving surgeries.

A Technology That Changes the Game in Surgery

Single-arm robotic surgery, with advantages such as less pain, a shorter hospital stay, a reduction in the need for a drain and high patient comfort, represents the point that contemporary surgery has reached.

When used together with appropriate patient selection and experienced surgeons, this technology improves surgical results while also making patients' surgical process markedly easier. In this respect single-arm robotic surgery can be considered not only as a new technique but as a development that is transforming the surgical approach.