Transvesical Clipless Robot-Assisted Radical Prostatectomy Using a Multiport Plat-form: Technical Feasibility and...

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is evolving with techniques to preserve continence anatomy.
• Transvesical RARP, especially with single-port platforms, is gaining interest.
• This study builds on prior clipless techniques to evaluate a multiport transvesical approach.

Purpose of the Study:

• To detail a step-by-step clipless transvesical RARP technique.
• To assess the feasibility of this approach.
• To report early functional and oncologic outcomes.

Main Methods:

• A multiport transvesical, line-of-sight RARP technique was used.
• Key steps included posterior release, cystotomy, bladder neck incision, clipless dissection, and urethrovesical anastomosis.
• Three patients with localized prostate cancer and moderate prostate volumes were included.

Main Results:

• All procedures were successfully completed with low perioperative morbidity.
• Early continence was observed in all three patients.
• One patient had a positive surgical margin; PSA levels were undetectable in all during early follow-up.

Conclusions:

• A reproducible, multiport, clipless transvesical RARP technique was demonstrated.
• The approach showed encouraging early functional outcomes in selected patients.
• Larger prostates and longer follow-up are needed to confirm durability.