Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System.

To investigate the feasibility and surgical technique of robotic perineal radical prostatectomy (RPRP).

We retrospectively analyzed 6 consecutive patients diagnosed with prostate cancer from December 2018 to May 2019 who underwent RPRP at our center. Perioperative outcomes were recorded for safety and feasibility analysis.

Six patients successfully underwent RPRP with no conversion to open procedures. Operative time was 140 (interquartile range [IQR] 123.75-148.75) min, console time was 70 (IQR 62.5-70) min, with an estimated blood loss of 125 (IQR 100-187.5) mL. Patients were discharged 2 days postoperatively (IQR range 1-3) with pelvic drainages removed. The Foley catheter was removed 2 weeks after surgery. Postoperative pathology revealed 5 patients with locally advanced disease (apical margin-positive prostate cancer [pT3a]bNx). Two patients had a positive surgical margin (33.3%). No complications of Clavien grade 3 and above were recorded; 1 patient had a delay in wound-healing of 1 week. Postoperative continence was achieved for 2 patients immediately after Foley catheter removal, 2 recovered 1-month postoperatively, and 1 recovered within 3 months, and 1 still had mild incontinence at the latest follow-up 1-month postoperatively.

RPRP is a safe and feasible alternative for the transperitoneal route in selected patients. Further investigation is required to assess its oncological and quality-of-life results.

Urologia internationalis. 2020 Apr 14 [Epub ahead of print]

Yifan Chang, Weidong Xu, Xiaojun Lu, Yi Zhou, Ming Ji, Yu-Tian Xiao, Yinghao Sun, Shancheng Ren

Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China., Department of Anesthesiology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China., Department of Urology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, China., Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China, .