Hood technique with the extraperitoneal approach for single port robot-assisted radical prostatectomy

The Hood technique focuses on preserving key periurethral structures to enhance urinary continence recovery. Here, we describe the extraperitoneal approach for the Hood technique for single-port robot-assisted radical prostatectomy (SP-RARP). Between December 2022 and January 2023, 5 patients underwent an extraperitoneal SP-RARP with the Hood technique. Functional and oncological outcomes were assessed at 3 and 12 months postoperatively. Continence was defined as the use of a 0-1 security pad. The median operative time was 165 (138 – 184) minutes. The estimated blood loss was 100 (50 – 150) mL. There were no perioperative complications, and no blood transfusions were administered. None of the cases required conversion to an intraperitoneal approach or an open surgical approach. Eighty percent (n=4) of the patients were discharged home on the day of surgery. All patients had the Foley catheter removed one week postoperatively. None of the patients required readmission at 30 days or 90 days after surgery. None of the patients had PSA persistence, or biochemical recurrence by 12 months. The continence rate at 3 months postoperatively was 80% (n=4). By 12 months, all patients reported being continent. The extraperitoneal approach for the Hood technique for SP-RARP is safe and feasible. It provides favorable functional and surgical outcomes and can be effectively implemented in urology programs experienced with SP-RARP.