Single-port surgery as a surgical platform: the K-SPS roadmap framework for terminology, description, and ergonomics

Single-port surgery (SPS) has evolved across laparoscopic and robotic technologies, yet its conceptual identity, terminology, and technical descriptions remain heterogeneous. The Korean Society of Single-Port Surgery initiated the K-SPS Roadmap Project to establish a common conceptual and descriptive framework for SPS. Expert discussions, formal voting, and simulator-based technical demonstrations were conducted during the K-SPS Roadmap Workshop. SPS was conceptualized as a surgical platform defined by single-site access rather than by a specific surgical system or commercial technology. Within this access-based framework, distinct access concepts, including the transabdominal single-port platform and vaginal natural orifice transluminal endoscopic surgery, can be distinguished from the laparoscopic or robotic systems used to perform surgery. Accordingly, a hierarchical nomenclature of Platform–System–Procedure was proposed to distinguish the fundamental access configuration from the technological system and the surgical operation performed. The use of “SP” as the preferred terminology and the Platform–System–Procedure hierarchy received 90.3% and 93.8% support, respectively. Descriptive review of simulator-session recordings identified recurring variations in surgeon posture, port configuration, and instrument grip, including perpendicular and rotated trunk-orientation patterns, six port configuration patterns, and conventional and reverse grip patterns for the left-hand instrument. These observations were not intended to define an optimal technique but to identify fundamental variables for describing how SPS is performed. The K-SPS framework provides a technology-neutral and extensible language for describing, comparing, teaching, and systematically investigating SPS, and may provide a foundation for future ergonomic evaluation, surgical education, and multicenter research.