Outpatient Extraperitoneal Single-Port Robotic Radical Prostatectomy

Area of Science:

• Urology
• Robotic Surgery
• Oncology

Background:

• Radical prostatectomy is a standard treatment for localized prostate cancer.
• Minimally invasive techniques aim to reduce patient recovery time and pain.
• The da Vinci SP platform offers a single-port approach for complex procedures.

Purpose of the Study:

• To evaluate the safety and feasibility of extraperitoneal single-port robotic assisted laparoscopic radical prostatectomy (ESRP).
• To assess the suitability of this procedure for same-day outpatient surgery.
• To determine perioperative outcomes including pain, opiate use, and length of stay.

Main Methods:

• Sixty patients with localized prostate cancer underwent ESRP using the da Vinci SP platform.
• An enhanced recovery protocol with minimal opiate use was implemented.
• Data on operative time, blood loss, complications, pain, discharge, and functional outcomes were collected prospectively and analyzed retrospectively.

Main Results:

• Mean operative time was 198 minutes with mean blood loss of 179 mL; no transfusions or intraoperative complications occurred.
• 37% of patients reported minimal pain (0-1) at discharge.
• 75% of patients were discharged the same day, with 96% discharged within 24 hours; median length of stay was 4.2 hours.
• Postoperative pad usage indicated good urinary function recovery, with 76% using 0-1 pads by 90 days.

Conclusions:

• ESRP with the da Vinci SP platform is a safe and reproducible option for same-day outpatient radical prostatectomy.
• The procedure allows for minimal opiate use, excellent pain management, and acceptable short-term functional and oncological outcomes.