Transvesical Single-Port Robotic Radical Prostatectomy on da Vinci Si: A Safe Access for Patients with Previous Open Surgery for Rectal Cancer

Objectives: To investigate the feasibility and safety of transvesical single-port robotic radical prostatectomy (tvspRRP) on patients with previous abdominal surgery and report their short-term function recovery outcomes. Methods: From September 2019 to January 2021, 12 patients with localized prostate cancer and history of open surgery for rectal cancer were retrospectively included. tvspRRP was performed on da Vinci Si by two high-volume surgeons with suprapubic access. Operative time, estimated blood loss, conversion rate, Clavien–Dindo complication, continence recovery, and quality-of-life scores were evaluated. Results: Patients were aged 62 to 79 years (mean ± SD, 70.4 ± 5.20 years), with a body mass index of 18.37 to 30.07 kg/m2 (mean ± SD, 24.2 ± 3.21 kg/m2). Baseline median prostate-specific antigen was 14.7 ng/mL (IQR: 8.78, 31.09) and median prostate volume was 32.8 mL (IQR: 31.07, 39.23). Mean operative time was 153.8 minutes (range, 80–310 minutes) with an estimated blood loss of 112.5 mL (range, 50–300 mL). No patient required blood transfusion. No Grade II or above complications were recorded. Positive surgical margin was 8.3% (1/12). No opioid analgesics or nonsteroidal anti-inflammatory drugs were used. Postoperative length of stay was 3.5 days (IQR, 2.25–4.25). Median follow-up time was 17.5 months (range, 8–24). Median biochemical recurrence-free survival was 17.0 months (IQR, 10.0, 20.25). A 3-, 6-, and 12-month continence recovery was 58.3% (7/12), 75.0% (9/12), and 87.5% (7/8), respectively. Conclusions: tvspRRP on da Vinci Si is a safe and feasible approach, and can be considered as an alternative approach for localized prostate cancer patients with previous abdominal surgery. Patient Consent: The authors have received and archived patient consent for video recording/publication in advance of video recording of procedure. No competing financial interests exist. Runtime of video: 3 mins 50 secs