To describe our surgical technique and early results for the single port (SP) transvesical robotic radical prostatectomy using the da Vinci SP surgical system.

Twenty patients underwent SP radical prostatectomy through a transvesical approach. Through a 3 cm suprapubic incision, the bladder was incised and a GelPOINT mini system was used for floating docking. Through the gel port, the dedicated SP robotic port, a 12 mm assistant port, and a flexible suction tubing were introduced.

All cases were completed successfully without need for extra ports or conversion. No intraoperative complications were recorded. Median (IQR) total robotic time was 119 (99-127) minutes. Median (IQR) estimated blood loss was 135 (100-162) mL. Median (IQR) hospital length of stay was 4.4 (3.9-22.2) hours. None of the patients required opioids use after discharge. Median (IQR) time with a Foley catheter after surgery was 4 (4Kaouk J, Valero R, Sawczyn G, Garisto J. Extraperitoneal single-port robot-assisted radical prostatectomy: initial experience and description of technique BJU Int 2020 ;  125 : 182-189 [cross-ref]

Cliquez ici pour aller à la section Références, 5Kaouk J, Sawczyn G, Wilson C, et al. Single-port percutaneous transvesical simple prostatectomy using the SP robotic system: initial clinical experience Urology 2020 ;  141 : 173-177 [inter-ref]

Cliquez ici pour aller à la section Références, 6Gandaglia G, Ploussard G, Valerio M, et al. A Novel nomogram to identify candidates for extended pelvic lymph node dissection among patients with clinically localized prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies Eur Urol 2019 ;  75 : 506-514 [cross-ref]

Cliquez ici pour aller à la section Références) days and 75% of the patients had immediate continence within 48 hours after Foley catheter removal. 85% were totally continent within 10 days after catheter removal. Three patients (15%) had positive surgical margins (all focal) on pathology. Two patients had transvesical lymph node dissection with 4 and 15 lymph nodes negative on final pathology.

We demonstrated the feasibility of SP robotic transvesical radical prostatectomy and pelvic lymph node dissection using a dedicated SP robotic platform. Favorable perioperative outcomes were seen, along with low complication rate, same day discharge, elimination of opioid requirement, and high rate of immediate recovery of continence as well as a low positive margin rate.