Single-port robotic radical prostatectomy: early results from a UK centre

Prostate cancer is the most common cancer affecting men in the United Kingdom. Single-port robot-assisted radical prostatectomy (SP-RARP) is one of the latest evolutions in the realm of minimally invasive surgery for prostate cancer. We aim to describe our institution's initial experience with single-port robot-assisted radical prostatectomy.

We retrospectively reviewed all the electronic theatre records to identify all patients undergoing Single-port robot-assisted radical prostatectomy. All cases were performed using the da Vinci SP Surgical System from September 2024 to December 2025. This review was registered and carried out in line with the Trust's audit & research guidelines.

A total of 50 patients underwent SP-RARP. The median patient age was 61 years, with a mean BMI of 27 kg/m² and an ASA grade distribution of 1-3. The median operative time was 120 min (86-180), and the median estimated blood loss was 100 mL (20-400). No intra-operative complications were recorded. Nerve-sparing was performed bilaterally in 25 patients, unilaterally in 22, and was not performed in 3 cases. The median initial post-operative pain score was 0.9, and the median length of stay was 1 day. At three months, 68% of patients were fully continent, and 75% achieved erectile function sufficient for intercourse with phosphodiesterase-5 inhibitors with or without vacuum device support. Final pathological staging showed pT2b disease in 3 patients, pT2c in 23, pT3a in 23, and pT3b in 1. A positive surgical margin greater than 3 mm was identified in one patient.

This represents the first UK case series of SP-RARP. Early outcomes demonstrate the procedure to be feasible and safe, with operative, oncological, and functional results comparable to published international SP-RARP data. These findings support the need for further comparative studies against multi-port RARP to better define the relative advantages of the single-port platform.