Single-port versus multiport robotic surgery in head and neck procedures: a systematic review and meta-analysis of surgical parameters.

Purpose: Single-port robotic platforms represent an emerging approach in head and neck surgery, yet their comparative effectiveness against traditional multiport systems remains unclear. Methods: A systematic review of PubMed, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to January 17, 2025. From 93 potentially relevant articles, 5 retrospective comparative studies met the inclusion criteria, comprising 1,000 patients (single-port, 453; multiport, 547). Random-effects meta-analysis was performed for operative parameters. Results: Single-port surgery demonstrated shorter docking times (pooled effect size, -1.05; 95% confidence interval [CI], -1.47 to -0.64) with moderate heterogeneity (I2 = 74.27%). Console times showed no significant difference between approaches (effect size, -0.05; 95% CI, -0.35 to 0.25). Total operative times, reported in 2 studies, indicated modest reductions with the single-port approach (295 ± 92 minutes vs. 315 ± 101 minutes; 101.9 ± 23.6 minutes vs. 114.9 ± 32.8 minutes). Major complication rates were comparable (single-port, 1.8%-9.7%; multiport, 2.7%-4.3%). Negative margin rates favored single-port procedures (57%-100% vs. 48%-92.6%). Conclusion: This systematic review suggests that single-port robotic surgery offers advantages in docking time while maintaining comparable safety profiles to multiport approaches in head and neck procedures. However, the quality of evidence remains low due to the observational nature of available studies and heterogeneity in outcome reporting.