Obesity is a core risk factor for various metabolic abnormalities. There is significant clinical overlap between patients with simple obesity and those with metabolic syndrome. Most patients with severe obesity present with complications such as hypertension and glucose/lipid metabolism disorders, which can easily progress to metabolic syndrome. Therefore, clinical bariatric surgery is not only used for weight reduction but also serves as an important means to correct metabolic disorders and treat metabolic syndrome.

Although the da Vinci SP system has demonstrated feasibility in upper gastrointestinal surgery, its application in bariatric surgery remains limited. Compared to laparoscopic surgery, multi-port robotic sleeve gastrectomy (RSG) has been widely adopted due to its higher surgical precision, stability, and ergonomic advantages. However, there have been no case series reports of pure SP-RSG (performed without any assistant ports). Since 2025, Professor Meng Hua’s team has successfully completed multiple cases of bariatric and metabolic surgery assisted by the SHURUI® Single-Port Surgical Robot with snake-like instruments. The relevant results were respectively published in the internationally renowned surgical journals Asian Journal of Surgery and Updates in Surgery, marking innovative clinical breakthroughs in the application of Single-Port Surgical Robot with snake-like instruments in the field of obesity and metabolic syndrome surgery.

These studies systematically included and reported cases of complex metabolic surgeries, including SHURUI® Single-Port Surgical Robot with snake-like instruments-assisted sleeve gastrectomy and Roux-en-Y gastric bypass, fully confirming the clinical value and application prospects of this minimally invasive technology in metabolic surgery. They provide a new, high-quality minimally invasive treatment option for patients with obesity and metabolic syndrome, effectively promoting the development of bariatric and metabolic surgery toward precision, extreme minimal invasiveness, and personalization.

Study One: Pure Single-Port Robotic Sleeve Gastrectomy

The results of this study were published on November 21, 2025, in the Asian Journal of Surgery. Robotic sleeve gastrectomy has significant minimally invasive advantages. However, pure single-port robotic sleeve gastrectomy (pure SP-RSG) without assistant ports has lacked clinical case series reports due to its high operational difficulty, representing a technical gap in the field of bariatric surgery. To investigate the safety and feasibility of this procedure, our center enrolled six obese patients with hypertension and type 2 diabetes to undergo surgical exploration, thereby validating the clinical application value of pure single-port bariatric surgery without assistant ports.

Clinical Data and Outcomes

This study enrolled six obese patients (4 females, 2 males) from July to September 2025. The average patient weight was 98.23±10.60 kg, with an average BMI of 34.18±3.01 kg/m². Half of the patients had hypertension, and 66.70% had type 2 diabetes. All patients received institutional ethics approval and signed informed consent forms before surgery.

The surgery uniformly utilized a 2.5 cm transumbilical single incision as the surgical approach, without using any auxiliary ports throughout the procedure. Pneumoperitoneum was established at 14 mmHg. The robot was docked from the patient's left side. Four robotic arms collaboratively completed all surgical maneuvers including liver retraction, gastric mobilization, stapling and transection, and seromuscular layer reinforcement. Clinical data showed an average operative time of 146.70±22.60 minutes, console time of 116.80±23.20 minutes, and mean intraoperative blood loss of only 7.00±3.20 mL, with no intraoperative complications.

Postoperative recovery was excellent. All patients were able to ambulate within 2 hours after surgery, resumed oral intake on the day of surgery, and were discharged smoothly on postoperative day 2. One-month follow-up results showed that average patient weight decreased to 85.78±5.31 kg, with a percentage total weight loss of 12.27±5.51% and significant reduction in body fat percentage. Meanwhile, patients showed spontaneous improvement in comorbidities such as blood pressure and fasting blood glucose without medication intervention. Umbilical incisions healed well with no postoperative complications such as wound infection, seroma, or abdominal wall hernia.

Significance of Study One

1.  Filling a Clinical Research Gap: This study is the first to report a consecutive case series of pure single-port robotic sleeve gastrectomy without auxiliary ports, validating the clinical technical feasibility of this innovative procedure and filling a case gap in related domestic and international fields.

2.  Optimizing the Minimally Invasive Bariatric Surgery System: Compared to traditional multi-port surgery, the pure single-port approach completely reduces abdominal wall puncture trauma, lowers the risk of complications related to abdominal wall injury, and significantly improves surgical cosmetic outcomes, meeting the aesthetic needs of young obese patients and enriching minimally invasive bariatric surgical options.

3.  Adapting to Surgical Needs of Special Obese Populations: Confirmed that this single-port robotic surgical platform can overcome the surgical difficulty of narrow abdominal operating space in centrally obese patients, expanding the applicable population for robotic bariatric surgery.

4.  Laying the Foundation for Future Research: Established the favorable early safety and rapid recovery advantages of the procedure, while objectively pointing out study limitations such as small sample size and short follow-up period. A prospective registered study has been initiated, providing research basis and direction for procedure standardization, learning curve optimization, and multi-center dissemination.

Study Two: World's First Pure Single-Port Robotic Roux-en-Y Gastric Bypass

Another study by Professor Meng Hua's team, titled "World’s First Report: Pure Single-Port Robotic Roux-en-Y Gastric Bypass in Patients with Metabolic Syndrome" was published on February 5, 2026, in the international SCI surgical journal Updates in Surgery. This journal is a authoritative peer-reviewed publication in the field of surgery, focusing on minimally invasive surgery and innovative clinical surgical techniques, publishing high-quality original clinical research with rigorous review processes and high recognition, possessing good international academic influence. The patient in this study was a 34-year-old Asian female with pathological obesity, BMI 29.5 kg/m², complicated by type 2 diabetes and grade 2 hypertension, representing a typical metabolic syndrome patient. After conservative lifestyle interventions including diet and exercise failed to improve her metabolic abnormalities and obesity symptoms, and her underlying diseases remained difficult to control, she met the indications for bariatric metabolic surgery and ultimately underwent Roux-en-Y gastric bypass assisted by the SHURUI® Single-Port Surgical Robot with snake-like instruments.

Clinical Outcomes and Significance

This study represents the world's first pure single-port gastric bypass completed using a single-port surgical robot with snake-like instruments, constituting an IDEAL Stage 1/2a early feasibility study. The surgery utilized the domestically produced single-port surgical robot with snake-like instruments, requiring only a single 2.5 cm umbilical incision without assistant ports. Leveraging the advantages of flexible bending, minimal instrument interference, and high-definition 3D stable visualization, the surgeon precisely completed gastric pouch creation, dual digestive tract anastomoses, and mesenteric defect closure, strictly adhering to standard surgical anatomical principles. The patient followed an enhanced recovery after surgery (ERAS) protocol, was able to ambulate and take liquids within 2 hours post-surgery, and was discharged smoothly on postoperative day 2. At two-month follow-up, the patient achieved a weight loss rate of 16.6%, significant reduction in body fat percentage, and complete remission of hypertension and hyperglycemia symptoms without medication maintenance. No complications such as incision infection or incisional hernia occurred throughout the process, effectively validating the safety and efficacy of the single-port surgical robot with snake-like instruments for complex metabolic surgeries.

Significance of Study Two

1.  Filling a Technical Gap: As the world's first report of pure single-port robotic gastric bypass, this study fills an academic and clinical gap in the field of complex bariatric metabolic surgery for domestically produced single-port robots. It solved the technical difficulties of traditional single-port surgery, including narrow operating space, easy instrument interference, and lack of an operating triangle, making multiple digestive tract anastomoses difficult to complete.

2.  Breaking Through Device Limitations: Leveraging the unique advantages of the domestically developed SHURUI® Single-Port Surgical Robot with snake-like instruments, including flexible bending and high degrees of freedom, the technology breaks through the technical barriers of traditional minimally invasive surgery. It greatly enhances the operability and precision of single-port procedures and broadens the application scope of conventional minimally invasive surgery.

3. Standardizing Clinical Techniques: The study established a standardized, replicable surgical procedure for pure single-port gastric bypass, providing a normative reference for clinical performance of related surgeries, while offering important academic support for subsequent research on learning curves and long-term efficacy.

4.  Optimizing Clinical Outcomes:The procedure abandons the traditional multi-port, multi-trocar surgical model, utilizing only a single concealed umbilical incision. While strictly adhering to standard anatomical principles and ensuring surgical efficacy, it reduces abdominal wall trauma, lowers the risk of complications, addresses both rapid patient recovery and abdominal wall aesthetics, and promotes the development of bariatric metabolic surgery toward extreme minimal invasiveness and precision.

Conclusion

In summary, the two clinical studies published by Professor Meng Hua's team in the Asian Journal of Surgery and Updates in Surgery, through case series of pure single-port robotic sleeve gastrectomy and Roux-en-Y gastric bypass, including the world's first procedure report, have confirmed on an evidence-based level the broad clinical applicability of the Shurui®  single-port surgical robot with snake-like instruments in bariatric metabolic surgery. This domestically produced equipment, leveraging its technical advantages of flexible snake-like instruments, anti-instrument interference, and high-definition 3D visualization, compensates for the operational limitations of the da Vinci SP system and traditional single-port laparoscopic surgery. It can perform not only basic bariatric procedures like sleeve gastrectomy but also difficult metabolic surgeries such as gastric bypass with digestive tract reconstruction, making it suitable for patients with simple obesity as well as those with metabolic syndrome complicated by diabetes and hypertension. This procedure, utilizing a transumbilical single-incision, no-assistant-port ultra-minimally invasive approach, ensures surgical safety and efficacy while achieving rapid patient recovery. Supported by high-quality clinical research validation and recognition from international journals, the Shurui® robot has broken the technological barriers of imported equipment. In the future, with continued device iteration and standardization of surgical techniques, it will further expand surgical indications and promote the high-quality development of bariatric metabolic surgery in China toward extreme minimal invasiveness, precision, and domestic innovation.