Feasibility and early outcomes of single-port robotic-assisted radical cystectomy with intracorporeal ileal conduit: an initial Spanish case series

Background: Single-port robotic-assisted radical cystectomy (SP-RARC) with intracorporeal urinary diversion (ICUD) represents a novel, minimally invasive approach for the surgical management of muscle-invasive bladder cancer (MIBC). While its feasibility has been demonstrated in high-volume centers, clinical experience remains scarce. We report the first Spanish experience with SP-RARC and ICUD, including perioperative outcomes and early postoperative results.

Case Description: A prospective case series registry including the first four patients who underwent SP-RARC with ICUD between April and June 2025 was conducted. All procedures were performed by a single high-volume robotic multiport surgeon using the da Vinci SP^® platform. Surgical steps postoperative management and early outcomes were standardized and recorded. All procedures were successfully completed using a single-port approach, without conversion to multiport or open surgery. No intraoperative complications occurred. The mean operative time was 249 minutes, with a mean estimated blood loss of 500 mL, a mean lymph node yield of 18.5, and a mean hospital stay of 6 days. Two patients (50%) experienced minor postoperative complications (Clavien-Dindo grade I–II); one required readmission for intravenous antibiotic therapy due to a febrile urinary tract infection. Final pathology revealed pT4aN0, pT1N0, pT3aN0 and pT4aN1. Surgical margins were negative in all cases.

Conclusions: SP-RARC with intracorporeal ileal conduit reconstruction was technically achievable in this initial case series when performed at an experienced robotic center. Given the limited cohort size and short follow-up, these findings should be interpreted as preliminary feasibility data requiring further validation in larger multicenter studies.