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Single Port Transvesical Robot Assisted Radical Prostatectomy.

Roxana Ramos1, Nicolas Soputro1, Adriana M Pedraza1

  • 1Urology Department, Cleveland Clinic, Cleveland, Ohio, USA.

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|March 18, 2025
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Summary

Single-port transvesical robot-assisted radical prostatectomy offers a minimally invasive approach for localized prostate cancer, enabling rapid recovery and excellent functional outcomes. This technique successfully treated 210 patients with minimal complications and short hospital stays.

Keywords:
minimally invasive surgical proceduresprostate cancerprostatic neoplasmrobotics

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Single-port (SP) transvesical (TV) robot-assisted radical prostatectomy (RARP) is an extraperitoneal approach for localized prostate cancer.
  • This technique leverages advanced robotic instruments for precise dissection and minimal tissue disruption.

Purpose of the Study:

  • To describe the updated surgical technique for SP TV RARP.
  • To discuss special scenarios and present updated outcomes from a large series of cases.

Main Methods:

  • The procedure involves a 3.5 cm midline incision for bladder access, followed by robotic dissection of the prostate.
  • Key steps include dissection of the bladder neck, seminal vesicles, neurovascular pedicles, and apex, followed by specimen extraction.
  • Vesicourethral anastomosis is reconstructed starting posteriorly and proceeding anteriorly.

Main Results:

  • In a series of 210 patients, all cases were completed successfully without conversion or additional ports.
  • Median console time was 2 hours with minimal blood loss (70 mL).
  • High rates of nerve-sparing procedures (87.1%), successful outpatient discharge (<24 hours for 92%), low pain scores, and minimal opioid use (96.2% without) were observed.

Conclusions:

  • SP TV RARP is a safe and effective technique for localized prostate cancer.
  • The approach facilitates rapid recovery, early return of function, and high patient satisfaction.