Use of peritoneal window and abdominal binder to reduce fluid collection after single-port robotic radical prostatectomy

Fluid collections are common after robot-assisted radical prostatectomy (RARP) with pelvic lymph node dissection (PLND). Literature about surgical techniques to reduce fluid collections after extraperitoneal single-port (SP) RARP is limited. This study evaluates the proposed technique of bilateral peritoneal windows and abdominal binder to reduce postoperative fluid collections in extraperitoneal SP RARP. An analysis of extraperitoneal SP RARP cases (January 2019-May 2024) was conducted using IRB-approved retrospective and prospective databases. Two surgeons implemented the bilateral peritoneal windows plus abdominal binder intervention. Patients were divided into pre-intervention and post-intervention groups. Outcomes, demographics, and complications between groups were compared. One hundred ninety-five pre-intervention and 194 post-intervention SP RARP patients were analyzed. Post-intervention patients had higher BMI (28.9 kg/m²vs. 27.7 kg/m², p = 0.018) and lymph node dissection rates (92.0% vs. 88.7%, p = 0.002), with shorter operating times (126.3 vs. 145.1 min, p < 0.001). Fluid collection rates decreased post-intervention (5.64% vs. 2.1%, p = 0.11), with fewer symptomatic cases (5.1% vs. 2.1%) and drainage requirements (2.0% vs. 1.54%). Non-fluid complications were significantly lower post-intervention during hospital stays (5.1% vs. 0%, p = 0.001). This study demonstrates that bilateral peritoneal windows and abdominal binder in extraperitoneal SP RARP may reduce incidence of postoperative fluid collection. The technique proved safe and efficient, with no bowel-related complications and shorter operating times. These findings highlight the efficacy of this approach and minimize patient burden due to this common complication.