Single-Port Percutaneous Transvesical Simple Prostatectomy Using the SP Robotic System: Initial Clinical Experience.

ABSTRACT

OBJECTIVE: To present our initial experience with single-port percutaneous transvesical simple prostatectomy using the novel SP robotic surgical system. METHODS: Ten patients underwent single-port transvesical simple prostatectomy between February and November 2019. Percutaneous access to the bladder dome was made and all SP instruments were inserted through the SP multichannel cannula directly into the bladder. Prostate adenoma enucleation, hemostasis and trigonization were done according to the principles of open simple prostatectomy technique. Demographics and perioperative outcomes were prospectively collected and analyzed. RESULTS: All procedures were performed successfully without the need for conversion to open surgery. Median preoperative estimated prostate size was 159 (Interquartile range (IQR) 108-223) grams. No intraoperative complications occurred. Median operative time and estimated blood loss were 190 (IQR 146-203) minutes and 100 (IQR 68-175) ml, respectively. Mean postoperative specimen weight was 84.3 ± 34 grams. Median length of hospital stay was 19 (IQR 17-28) hours. All patients were satisfied with their urinary flow after catheter removal without any episode of acute urinary retention 1-6 months, postoperatively. CONCLUSION: Single-port transvesical simple prostatectomy can be offered as an alternative treatment option for surgical management of lower urinary tract symptoms associated with large prostate adenoma. Sparing the peritoneal cavity, minimum dissection of the bladder, excellent visualization of the prostate fossa can be some of the potential advantages of this minimally invasive approach. Comparative studies with standard techniques are advisable to evaluate the surgical outcome and postoperative morbidity of each treatment modality.