Single Port Robot-Assisted Simple Prostatectomy

Abstract Purpose of Review To describe the surgical techniques and evaluate the perioperative and functional outcomes associated with robot-assisted simple prostatectomy (RASP) performed using the purpose-built Single Port (SP) robotic platform. Recent Findings Based on a comprehensive review of the current literature, the Transvesical approach represents the most preferred technique for SP-RASP. When compared with the open simple prostatectomy or traditional multi-port robotic surgical approaches, the SP Transvesical Enucleation of the Prostate (STEP) was associated with a reduced risk of perioperative complications, postoperative pain, Foley catheter duration as well as the need for continuous bladder irrigation, hence shortening the hospital length of stay and improving the overall patient comfort. Compared to the endoscopic enucleation techniques, STEP also conferred an additional benefit in reducing the risk of de novo urinary incontinence, especially given the maximal preservation of the urethra, the external urinary sphincter, and the supporting structures of the bladder. Summary SP-RASP represents a safe and feasible alternative for the management of large volume benign prostatic hyperplasia (BPH). Despite the comparable functional improvements to other RASP and endoscopic enucleation techniques, appreciating the technical differences and additional clinical benefits of the more regionalized STEP approach remains important to guide our patient selection and education, especially in patients who are less willing to accept the risk of postoperative urinary incontinence, as well as those with unfavorable urethral access and concurrent bladder pathologies.