fig2

Figure 2. Port layout and 90° rotational reconfiguration for right-sided UTUC. A 5-cm multichannel single-site platform is used. Instrument assignment: port #1 Cadiere forceps (left working arm), port #3 scissors (right working arm), and port #2 camera (initially oriented at 12-o’clock), port #5 assistant port. Two accessory incisions may be added at the surgeon’s discretion: port #4 (8 mm), 2 cm cranial to the ipsilateral ASIS, docks the fourth arm for sustained peritoneal traction and gentle bowel sweeping; port #6 (8 mm), subxiphoid, is used only in right-sided cases when hepatic retraction is required. Neither port is mandatory, and their placement does not alter the single-position workflow. Prior to distal ureter dissection and cuff excision, the first step is a 90° axial rotation of the single-site platform - clockwise for left-sided and counterclockwise for right-sided UTUC - redirecting the camera caudally (12 → 3 left-sided; 12 → 9 right-sided). This is then followed by patient-cart axis rotation and an overhead-boom swing into the pelvic quadrant. UTUC: Upper tract urothelial carcinoma; ASIS: anterior superior iliac spine.