How to cite: Badal J. “From the Abdomen to the Retroperitoneum – My Path to Single Port Robotics.” September 19, 2025. Accessed Feb 2026. https://grandroundsinurology.com/from-the-abdomen-to-the-retroperitoneum-my-path-to-single-port-robotics/
Summary
Justin J. Badal, MD, Assistant Professor of Urology, Baylor College of Medicine, Houston, Texas, discusses his clinical experience transitioning from traditional multi-port to single-port robotic surgery using the da Vinci SP system. He explains that the da Vinci SP platform allows surgeons to perform complex procedures through a single 2.5 cm incision using articulating instruments and a flexible camera that facilitates work in confined spaces.
Dr. Badal discusses the initial learning curve and ergonomic differences encountered during the adoption of single-port robotic surgery. He emphasizes the importance of patient positioning, trocar placement, and docking orientation to achieve optimal visualization and instrument reach. Early cases focused on transperitoneal access for nephrectomy and partial nephrectomy, where familiar anatomy supported safe technique refinement before advancing to more confined retroperitoneal procedures.
He explains that the retroperitoneal approach minimizes bowel mobilization, reduces postoperative pain, and shortens recovery time. Dr. Badal describes adapting port trajectory, instrument articulation, and dissection angles to maintain precision within the limited working space. He notes that early institutional data suggest comparable operative times, complication rates, and margin control relative to multiport systems, with potentially faster convalescence.
Dr. Badal argues that careful patient selection, meticulous procedural planning, and ongoing simulation-based training are crucial for the successful integration of single-port robotic surgery. He anticipates expanded indications as the technology matures and experience grows, allowing urologists to further refine minimally invasive approaches to complex retroperitoneal surgery.
About The 29th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma, men’s health topics like male infertility and sexual dysfunction, and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Justin J. Badal, MD, is a urologic surgeon and the Assistant Professor of Urology at Baylor College of Medicine in Houston, Texas. Dr. Badal has clinical interests in managing prostate and kidney cancers with minimally invasive techniques. His research interests focus on the cross-section of medicine and emerging technologies, including the development of advanced robotic skills to remain at the forefront of medical education and oncologic care for genitourinary malignancies.
