MP57-10: Single-port Extraperitoneal Robotic-assisted Radical Prostatectomy: A Multi-Institutional Cohort Study

Mahmoud Abou Zeinab*, Ethan Ferguson, Aaron Kaviani, Alp T. Beksac, Cleveland, OH, Luca Morgantini, Susan Talamini, Chicago, IL, Jean Joseph, Rochester, NY, Moses Kim, Laguna Hills, CA, Simone Crivellaro, Chicago, IL, Jeffrey Nix, Birmingham, AL, Jihad Kaouk, Cleveland, OH

Introduction: Robotic-assisted radical prostatectomy through the extraperitoneal approach has increased in popularity after the introduction of the single-port (SP) da Vinci platform. We sought to evaluate the perioperative and postoperative outcomes in a multi-institutional setting.

Methods: From February 2019 to October 2021, data of 412 patients who underwent SP extraperitoneal radical prostatectomy (ERP) in five different institutions were prospectively collected. All procedures were performed by surgeons with extensive robotic and SP experience. Baseline demographics, intraoperative, functional, and short oncological outcomes were evaluated.

Results: The median follow-up was time was 8 months. The median cohort age, BMI, and preoperative PSA were 64 years, 29 kg/m2, and 6.6 ng/mL respectively. 23.8% of the cohort were at high-risk prostate cancer according to the NCCN classification. Almost 30% of the patients had at least one previous abdominal surgery. The median operative time and estimated blood loss were 205 minutes and 150 cc, respectively. A nerve-sparing approach was performed in more than 90% of the patients and 3 cases had peritoneal breach.  On pathology, the positive surgical margins were 26.8% and the median lymph node yield was 6 nodes. Most of the patients were discharged a few hours after the surgery with a median pain score of 2.  In the postoperative phase, 50% and 90% of the patients were continent within 3 and 6 months, respectively. 40% of the patients restored their sexual function by 6 months.

Conclusions: The Single-port extraperitoneal robotic-assisted radical prostatectomy is a minimally invasive approach in the management of localized prostate cancer. It is a suitable approach for patients with previous abdominal surgeries. This approach offers patients with promising outcomes in terms of single incision, minimal pain and same-day discharge without compromising the functional or oncologic outcomes.

Source of Funding: None