Single-port robotic surgery in endometrial cancer: current evidence, challenges, and future perspectives

The introduction of the da Vinci Single-Port (SP) surgical platform marks a significant milestone in the evolution of minimally invasive surgery for gynecologic malignancies. This review aims to evaluate the current clinical evidence, perioperative and oncologic outcomes, technical limitations, and future directions of SP robotic surgery in the management of endometrial cancer (EC), based on a PubMed search conducted in May 2026. Available evidence suggests that SP robotic surgery is a feasible and safe option for selected patients with early-stage EC, demonstrating operative times, estimated blood loss, lymph node yield, conversion rates, and perioperative complication rates comparable to those of conventional multiport robotic surgery. Although long-term oncologic data remain limited, progression-free and overall survival outcomes reported to date appear comparable across surgical platforms. Potential advantages of SP robotic surgery include improved cosmetic satisfaction, reduced docking time, and less abdominal wall trauma, whereas evidence regarding postoperative pain reduction remains inconsistent. Despite these promising findings, several challenges—including a limited evidence base, technical complexity, learning-curve considerations, and cost-related barriers—continue to restrict widespread implementation. Overall, SP robotic surgery represents a promising alternative to conventional robotic surgery for EC, although further large-scale prospective studies with long-term oncologic follow-up are needed to define its role in contemporary gynecologic oncology.