Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Radical prostatectomy is a standard treatment for localized prostate cancer.
• Minimally invasive approaches, including robotic surgery, aim to improve patient outcomes.
• The perineal approach for radical prostatectomy offers potential advantages but has been less explored with robotic assistance.

Purpose of the Study:

• To evaluate the feasibility and safety of robotic perineal radical prostatectomy (RPRP).
• To describe the surgical technique for RPRP.
• To analyze perioperative outcomes of RPRP.

Main Methods:

• Retrospective analysis of 6 consecutive patients undergoing RPRP for prostate cancer.
• Data collected included perioperative outcomes, operative time, console time, estimated blood loss, and complications.
• Follow-up included assessment of surgical margins, wound healing, and urinary continence.

Main Results:

• All 6 patients successfully underwent RPRP without conversion to open surgery.
• Mean operative time was 140 minutes, console time 70 minutes, with low estimated blood loss (125 mL).
• No major complications (Clavien grade ≥3) occurred; one patient had delayed wound healing. Postoperative continence varied, with 3 of 6 patients continent within 3 months.

Conclusions:

• Robotic perineal radical prostatectomy (RPRP) is a safe and feasible alternative to the transperitoneal approach in select prostate cancer patients.
• The technique demonstrated acceptable perioperative outcomes.
• Further research is needed to confirm long-term oncological control and quality-of-life benefits.