Introduction: The da Vinci Single-Port (SP) robotic system represents a newer minimally invasive surgical development with greater articulation and reduced surgical footprint through the use of a single incision. While originally applied in urology and otolaryngology, its application in general surgery is on the rise. This review aims to delineate the current applications, outcomes, and limitations of the SP platform in general surgical procedures. Methods: A descriptive literature search of PubMed, Scopus, and Embase databases was conducted to identify relevant peer-reviewed studies up to September 2025. The included studies reported SP robotic surgeries in various fields of general surgery. Results: A growing body of literature was found that reports the safety and feasibility of SP robotic surgery within general surgery. Advantages reported include improved cosmesis, decreased postoperative pain, and shorter recovery time. The present evidence is largely made up of small case series and initial feasibility studies. Technical drawbacks, such as crowding of instruments and a learning curve, remain issues. Conclusions: The da Vinci SP system shows promising potential for application in general surgery, particularly for certain procedures. Additional prospective studies and larger case series need to outline its long-term results, cost-effectiveness, and optimal indications.

Backgrounds: Liver surgery has developed progressively during the last 10 years, especially in minimally invasive approaches. Robotic surgery seemed to overcome laparoscopic limitations with 3D visualization, the increased degrees of freedom given with Endowrist instruments, tremor filtering, better dexterity, and improved ergonomics for the surgeon. Methods: This work was a retrospective analysis of our first 100 robotic hepatectomies from March 2020 to July 2022. Patient demographics characteristics and intra- and postoperative outcomes were analyzed. Results: A total of 59 males and 41 females, with a median age of 68 years, underwent a robotic liver resection. The indications for robotic liver resections were malignant lesions in 86% of patients. Anatomical resection (AR) was undertaken in 27% of cases and non-anatomical resection (NAR) in 63% of cases. None of the patients were converted to the ‘open’ approach. Postoperative complications were as follows: 1% of biliary leakage, 5% of ascites, 6% of pulmonary infections, and 3% of other sites’ infections. CONCLUSIONS Our results showed the satisfactory experience of a tertiary HPB center with its first 100 robotic liver resections. The opportunity to make the robotic approach routinary provided global growth of a surgical team, improving the quality of patient outcomes.

Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with a poor prognosis. Negative-margin resection is presently the only potentially curative treatment option. Emerging trends with direct applicability to surgical strategy include margin thickness, lymphadenectomy, optimization of future liver remnant (FLR), minimally invasive techniques, incorporation of systemic therapy, and reconsideration of liver transplantation. This review emphasizes areas of consensus and ongoing debate. Margins ≥5–10 mm are associated with improved results, but biology generally takes precedence over prognosis. Regional lymphadenectomy enhances staging accuracy, although its therapeutic benefit remains unsettled. PVE is standard for FLR enlargement, LVD provides faster hypertrophy, and ALPPS remains reserved for highly selective cases. Minimally invasive and robotic hepatectomy share oncologic results in skilled institutions. Systemic therapies, including immunotherapy and biomarker-directed targeted therapy, are increasingly being incorporated perioperatively. Liver transplant may be of potential value in early-stage disease or on strict indications after neoadjuvant treatment. The modern surgical management of iCCA encompasses a blend of oncologic considerations, FLR optimization, minimally invasive surgery, and systemic therapy according to tumor biology. Multidisciplinary planning and participation in clinical trials are necessary to align surgical innovation with advancements in molecular and systemic treatments, ultimately leading to improved long-term outcomes.

Robotic pancreaticoduodenectomy (RPD) has emerged as a viable alternative to open and laparoscopic approaches, offering potential advantages in precision and dexterity. However, its complexity and lack of standardization remain as barriers to widespread adoption. We present a step-by-step surgical approach to RPD, emphasizing key technical strategies to enhance safety, efficiency, and reproducibility. Our technique is structured into defined surgical steps, facilitating learning curve optimization and intraoperative consistency. Key refinements include an optimized trocar placement, the strategic suspension of vascular structures, and specific reconstructive techniques to reduce the operative time and improve surgical ergonomics. These improvements may contribute to a reduction in perioperative morbidity and procedural standardization. Standardizing RPD through defined surgical steps and structured learning pathways may improve its feasibility, safety, and broader adoption. Further studies are needed to validate these strategies in high-volume centers.

Background: Robotic pancreaticoduodenectomy (RPD) is a less invasive alternative to open pancreaticoduodenectomy (OPD) with the potential for perioperative advantage. Concerns remain regarding its technical difficulty, cost, and oncologic adequacy. Methods: Review of PubMed, MEDLINE, Scopus, and Embase databases was conducted (January 2000–October 2025), focusing on systematic reviews, meta-analyses, and significant comparative studies of RPD. Outcomes assessed were perioperative outcomes, oncologic sufficiency, learning curve, model training, cost-effectiveness, and future developments. Results: Several studies report comparable R0 rates and lymph node yield between RPD and OPD, with reduced blood loss, shorter postoperative hospital stay, and faster recovery in high-volume centers. Morbidity (35–50%) and 90-day mortality (<2%) are similar to open or laparoscopic surgery. Competence is usually achieved after 40–60 cases, while optimal outcomes are achieved after 80–100 procedures. Structured mentorship and simulation training improve safety and reproducibility. Novel technologies such as augmented reality, intraoperative fluorescence, and artificial intelligence-based navigation may also enhance accuracy and shorten the learning curve. Conclusions: RPD appears to be a safe and effective minimally invasive option in carefully selected patients if done in specialized, high-volume centers. Future studies need to resolve long-term oncologic results, cost-effectiveness, and the role of next-generation robotic systems.

Background: The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a surgical strategy for patients with advanced liver tumors and inadequate future liver remnants (FLR). This study compares post-operative outcomes between open (oALPPS) and robotic (rALPPS) ALPPS in our institution. Methods: This retrospective monocentric study includes eleven patients who underwent ALPPS procedure between January 2023 and February 2024. Demographics, tumor characteristics, and intra- and post-operative outcomes were collected and analyzed. Results: In the first-stage ALPPS, the frequency of intermittent hilum clamp and the estimated blood loss were higher in the oALPPS group, while operative time and complications were similar, and total hospital stay was higher in the rALPPS group. In the second-stage ALPPS, the data regarding intraoperative and post-operative data were similar. In rALPPS, there were no post-discharge complications, readmissions, or deaths within 30 days. Conclusion: This single-center study has an exploratory setting given the small cohort, but if confirmed in larger studies, rALPPS could be a viable alternative to oALPPS.