Primary Clinical Application of the Shurui Single-Port Robotic Surgical System in Upper Urinary Tract Reconstruction: A Prospective Single-Center Study

Background: XXXX. To evaluate the safety, feasibility, and early functional outcomes of the Shurui single-port (SP) robotic surgical system in patients undergoing upper urinary tract reconstruction.

Methods: Between May 2024 and August 2025, 17 consecutive patients with ureteral stricture underwent single-port robot-assisted reconstruction at a single center. Procedures included robot-assisted pyeloplasty (RAP, n=10), ureteroureterostomy (RUU, n=1), and ureteroneocystostomy (RUNC, n=6), all performed via a single 2.5–3.0 cm periumbilical incision using the Shurui SP system. Perioperative data, surgeon workload assessed by the National Aeronautics and Space Administration Task Load Index (NASA-TLX), and functional outcomes were prospectively collected. Clinical success was defined as symptom resolution without worsening, tube-free status, and no worsening of hydronephrosis on follow-up imaging.

Results: All procedures were completed successfully without conversion to open surgery or need for additional ports. The median operative time was 210.0 minutes (interquartile range [IQR]: 205.0–245.0), with a median docking time of 4.0 minutes (IQR: 3.0–7.0) and console time of 139.0 minutes (IQR: 115.0–180.0). Median estimated blood loss (EBL) was 10.0 mL (IQR: 5.0–20.0), with no transfusions required. The mean NASA-TLX score was 4.97±4.34 (IQR 2.0–6.5), indicating low ergonomic burden. Median postoperative hospital stay was 4.0 days (IQR: 4.0–6.0). At a median follow-up of 8.0 months (IQR: 6.0–8.0), no treatment failures were observed in this small cohort (N=17): all patients achieved symptom resolution and imaging confirmed relief of obstruction with resolution of hydronephrosis, and no Clavien-Dindo grade ≥ II complications occurred. Median estimated glomerular filtration rate (eGFR) at last follow-up was 105.4 mL/min/1.73 m².

Conclusions: The Shurui SP robotic surgical system demonstrated favorable short-term safety and feasibility across diverse upper urinary tract reconstructive procedures. Within a median follow-up of 8.0 months, no failures or major complications were observed; however, because stricture recurrence may present late, longer-term surveillance is required to confirm durable patency. These preliminary results support the clinical viability of this platform for ureteral reconstruction and warrant further validation in larger, comparative studies with extended follow-up.